Women's Healthhttp://www.minnpost.com/taxonomy/term/2286/all
enWith layers of rules and restrictions, is Roe a reality anymore?http://www.minnpost.com/community-voices/2015/01/layers-rules-and-restrictions-roe-reality-anymore
<p>As we approach the 42nd&nbsp;anniversary of&nbsp;<i style="font-size: 16px; line-height: 1.5em;">Roe v. Wade,</i>&nbsp;the Jan. 22, 1973, Supreme Court decision that&nbsp;legalized abortion in the United States, we reflect on how it dramatically bolstered women’s health and dignity.</p><div class="image float-right"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/ho-nguyen_head.jpg" alt="" title="Ho Nguyen" /><div class="credit"></div><div class="caption">Ho Nguyen</div></div><p>After three blissful years of uninterrupted access to the right to obtain an abortion, 1976 marked the beginning of a 40-year avalanche of targeted restrictions and regulations preventing people and their family’s access to a safe and legal abortion procedure. So, what is legal abortion without access? Who is granted this right? Who are the people and the communities that face an undue burden of obstacles just to obtain a legal procedure that has been granted to them by the Supreme Court?</p><p>As Supreme Court Justice Ruth Bader Ginsberg and countless other reproductive health, rights, and justice advocates have said again and again: Women with means will always find a way to travel and afford their care. Women without means, women without access to money and transportation, will always be the ones facing obstacles.</p><h4>Making abortion costly, hard to obtain</h4><p>Anti-choice politicians often target groups of people and communities that are already systemically and institutionally marginalized in an effort to make abortion harder and harder to access.&nbsp;Politicians use bans on abortion coverage, waiting periods, medically inaccurate scripts, and medically unnecessary laws (such as dictating the width of the halls of a clinic) to make abortion harder to get, and more expensive.</p><div class="float-left"><div class="minnpost-ads-ad minnpost-ads-ad-Middle "><script type="text/javascript">OAS_AD("Middle");</script></div></div><p>The reality is that these regulations do nothing to make abortion safer or help a woman with her decision — but they do make getting an abortion more costly and difficult.&nbsp;In these cases, low-income people, young people, and communities of color are the most affected. In 1976, then-U.S. Rep. Henry Hyde said, “I would certainly like to prevent, if I could legally, anybody having an abortion: a rich woman, a middle class woman, or a poor woman. Unfortunately, the only vehicle available is the [Medicaid] bill.” Medicaid is a federal health-care program designed to aid our most economically vulnerable populations.</p><h4>Burden falls on rural women, the poor and women of color</h4><p>When we parse out the scale of impact we can see that this burden falls on communities of color, low-income communities and rural communities. We begin to wonder how <i>Roe</i>&nbsp;can be a reality when so many people are prevented from accessing it.&nbsp;When we support and respect that personal health decisions are ours to make, we are all stronger. Instead of restricting reproductive health care — including abortion care — we need solutions to improve all aspects of our health.</p><p>To make <em>Roe</em> a reality for all people again, we must continue to shed light to restrictions and regulations that are disguised as safety measures for women and families and see them for what they are: an unjust elimination of abortion care.&nbsp;</p><p><i>Ho Nguyen is the grassroots advocacy coordinator&nbsp;for&nbsp;</i><i style="font-size: 16px; line-height: 1.5em;"><a href="http://www.prochoiceresources.org">Pro-Choice Resources</a></i><i style="font-size: 16px; line-height: 1.5em;">.&nbsp;</i></p><h5><b>WANT TO ADD YOUR VOICE?</b></h5><p>If you're interested in joining the discussion, add your voice to the Comment section below — or consider writing&nbsp;<a href="http://www.minnpost.com/submit-letter">a letter</a>&nbsp;or a longer-form&nbsp;<a href="http://www.minnpost.com/community-voices">Community Voices</a>&nbsp;commentary. (For more information about Community Voices, email&nbsp;<a href="http://www.minnpost.com/author/susan-albright">Susan Albright</a>&nbsp;at&nbsp;<a href="mailto:salbright@minnpost.com">salbright@minnpost.com</a>.)</p>http://www.minnpost.com/community-voices/2015/01/layers-rules-and-restrictions-roe-reality-anymore#commentsWomen's HealthTue, 20 Jan 2015 11:00:00 +0000By Ho Nguyen90703 at http://www.minnpost.comPharma companies spend millions wooing doctors to prescribe 'me-too' drugshttp://www.minnpost.com/second-opinion/2015/01/pharma-companies-spend-millions-wooing-doctors-prescribe-me-too-drugs
<div class="image float-right"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/XereltoBox325.png" alt="Xarelto package" title="Xarelto package" /><div class="credit">Bayer</div><div class="caption">Xarelto package</div></div><p>Is the drug you’re taking the safest and most effective one for your medical condition, or is it a “me-too” drug&nbsp; — one that essentially duplicates the actions of an already existing drug, but at a higher price?</p><p>As <a target="_blank" href="http://www.propublica.org/article/vying-for-market-share-companies-heavily-promote-me-too-drugs">a new investigative article</a> from <a target="_blank" href="http://www.propublica.org/about/">ProPublica</a> reporters <a target="_blank" href="http://www.propublica.org/site/author/charles_ornstein">Charles Ornstein</a> and <a target="_blank" href="http://www.propublica.org/site/author/ryann_jones">Ryann Grochowski Jones</a> points out, pharmaceutical companies spend millions of dollars wooing physicians to prescribe “me-too” drugs to their patients. They do this, in part, with free meals and educational gifts and by hiring physicians as consultants and promotional speakers. (And, yes, although most physicians will say that small gifts, such as free meals, have no influence on <i>their</i> prescribing preferences, <a target="_blank" href="http://www.scu.edu/ethics/publications/submitted/morreim/prescribing.html">research suggests otherwise</a>. Pharmaceutical companies know this; that’s why they spend so much money on those gifts.)</p><p>In the last five months of 2013 alone, the manufacturers of just three new blood-thinning drugs (<a target="_blank" href="http://www.drugs.com/pro/pradaxa.html">Pradaxa</a>, <a target="_blank" href="http://www.drugs.com/xarelto.html">Xarelto</a> and <a target="_blank" href="http://www.drugs.com/eliquis.html">Eliquis</a>) spent almost $19.4 million on U.S. doctors to encourage them to prescribe one of those drugs rather than the much-older blood thinner <a target="_blank" href="http://www.drugs.com/coumadin.html">Coumadin</a> (warfarin), according to the ProPublica report.</p><div class="float-left"><div class="minnpost-ads-ad minnpost-ads-ad-Middle "><script type="text/javascript">OAS_AD("Middle");</script></div></div><p>Ornstein and Jones compiled that payment information from the <a target="_blank" href="http://www.cms.gov/openpayments/index.html">Open Payments database</a>, which has come into existence because of the <a target="_blank" href="http://www.hhs.gov/healthcare/rights/index.html">Affordable Care Act</a>. Their resulting investigation provides “the first comprehensive look at how much money drug and device companies have spent working with doctors,” the two reporters write. “What it shows is that the drugs most aggressively promoted to doctors typically aren’t cures or even big medical breakthroughs. Some are top sellers, but most are not. Instead, they are newer drugs that manufacturers hope will gain a foothold, sometimes after failing to meet Wall Street’s early expectations.”</p><p>“In almost all cases, older, cheaper products are available to treat the same conditions,” Ornstein and Jones add. “Companies typically try to differentiate the new drugs by claiming they are easier to use; carry fewer side effects; work faster than competitors; or have medical advantages.”</p><h4><b>Top three</b></h4><p>According to the ProPublica analysis, the drugs associated with the most payments ($9 million) to doctors during those five months in 2013 was <a target="_blank" href="http://www.drugs.com/pro/victoza.html">Victoza</a>, a diabetes medication made by Novo Nordisk.</p><p>“Victoza, through a once-a-day injection, helps lower blood sugar among diabetics, but researchers and advocacy groups have said drugs of its class carry an increased risk of thyroid cancer and pancreatitis,” write Ornstein and Jones. (A Novo Nordisk spokesperson told the reporters that the company had to spent that much money on doctors to address such safety concerns.)</p><p>Second and third on the list were Eliquis, the blood thinner (anticoagulant) co-marketed by Bristo-Myers Squibb and Pfizer ($8 million), and <a target="_blank" href="http://www.drugs.com/brilinta.html">Brilinta</a>, a blood thinner made by AstraZeneca.</p><h4><b>Majority are new drugs</b></h4><p>Among the 20 most-promoted drugs identified in this study, 14 were new drugs — approved by the Food and Drug Administration since 2010. Write Ornstein and Jones:</p><blockquote><p>Some treat similar conditions, including diabetes, schizophrenia and chronic obstructive pulmonary disease, so the competition among them is fierce. “They’re fighting over the same doctors, I guarantee you,” said Rhonda Greenapple Simoff, founder of a consulting firm that advises pharmaceutical companies in Bernardsville, N.J.</p><p>Largely absent from the top of the list were drugs that cure disease, such as a new class of hepatitis C treatments, or those that significantly extend life, particularly for cancer patients. If a drug is either the first to treat a disease or is much better than existing drugs, said Dr. Sidney Wolfe, the founder and now senior adviser to Public Citizen’s Health Research Group, “they ‘sell themselves’ on the merits of their unique benefits.”</p><p>According to ProPublica’s analysis, a few of the most heavily promoted drugs, including <a href="http://www.fda.gov/Drugs/DrugSafety/ucm350062.htm">Samsca</a>, which treats low sodium levels in the blood, have serious side effects that came to light after their approval by the federal government. The manufacturers of several others, including <a href="http://www.fda.gov/downloads/Drugs/.../UCM296204.pdf">Copaxone</a>, <a href="http://www.fda.gov/downloads/Drugs/.../UCM283666.pdf">Latuda</a>, <a href="http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/WarningLettersandNoticeofViolationLetterstoPharmaceuticalCompanies/UCM357833.pdf">Xarelto</a>, <a href="http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/WarningLettersandNoticeofViolationLetterstoPharmaceuticalCompanies/UCM314572.pdf">Daliresp</a> and <a href="http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/WarningLettersandNoticeofViolationLetterstoPharmaceuticalCompanies/ucm053941.pdf">Humira</a>, have been faulted by the F.D.A. for improper promotion.</p></blockquote><h4><b>For more information</b></h4><p>You can read the full article <a target="_blank" href="http://www.propublica.org/article/vying-for-market-share-companies-heavily-promote-me-too-drugs">on the ProPublica website</a>. (It was co-published with the New York Times' <a target="_blank" href="http://www.nytimes.com/upshot/">The Upshot</a>.) The article includes a chart of the top 20 most-promoted drugs during the last five months of 2013.</p><p>In addition, you’ll find <a target="_blank" href="http://projects.propublica.org/open-payments/">a useful app</a> on the site that can help you see how much money is being spent on doctors (and teaching hospitals) to encourage them to promote a drug you are taking. ProPublica also has a <a target="_blank" href="http://projects.propublica.org/docdollars/">“Dollars for Docs”</a> tool that can help you determine if your physician has received payments from a drug or medical device company.</p>http://www.minnpost.com/second-opinion/2015/01/pharma-companies-spend-millions-wooing-doctors-prescribe-me-too-drugs#commentsNationScienceWomen's HealthHealthpharmaceutical companiesFri, 09 Jan 2015 16:00:52 +0000Susan Perry90588 at http://www.minnpost.com'Betty was for women': Hazelden’s Women’s Recovery Center renamed to honor former first ladyhttp://www.minnpost.com/mental-health-addiction/2014/10/betty-was-women-hazelden-s-women-s-recovery-center-renamed-honor-for
<p>The late first lady <a href="http://www.nytimes.com/2011/07/09/us/politics/betty-ford-dies.html?pagewanted=all&amp;_r=0" target="_blank">Betty Ford</a> was known for her support of women’s rights as well as her battles with addiction, so it only made sense for the merged <a href="http://www.minnpost.com/glean/2013/09/its-deal-betty-ford-and-hazelden-merge" target="_blank">Hazelden Betty Ford Foundation</a> to rename its Women’s Recovery Center in her honor.</p><p>“For most people under age 40, there’s not much knowledge about Mrs. Ford and her legacy,” said Mark Mishek, Hazelden Betty Ford Foundation CEO. “When we agreed to this merger, one of the promises we made was to honor Mrs. Ford’s legacy, to tell a broader audience about her great courage. To cement the merger, we agreed early on to rename our Women’s Recovery Center in Mrs. Ford’s honor. It made perfect sense, because Betty was for women.”&nbsp;</p><p>Last week, a group of foundation employees and supporters gathered at Hazelden’s Center City campus for the dedication event. Speakers, including <a href="http://geraldrfordfoundation.org/centennial/oralhistory/susan-ford-bales/" target="_blank">Susan Ford Bales</a>, youngest child of Gerald and Betty Ford and former chair of the Betty Ford Center; and <a href="http://www.npr.org/people/2101090/cokie-roberts" target="_blank">Cokie Roberts</a>, NPR Morning Edition contributor, spoke of the importance of providing focused and accessible recovery care for women. Their speeches were transmitted via live feed to the <a href="http://www.bettyfordcenter.org/index.php" target="_blank">Betty Ford Center campus in Rancho Mirage, California</a>. &nbsp;&nbsp;</p><p>The event, which Mishek characterized as an “internal event designed to show the commitment and dedication of the new organization to carry Mrs. Ford’s legacy into the future,” featured the unveiling of an original bust of the former first lady specifically commissioned for the building and <a href="http://www.jbgsculpture.net" target="_blank">created by artist Brett Grill</a>.<a href="http://www.jbgsculpture.net" style="font-size: 16px; line-height: 1.5em;"><br /></a></p><h4>Historical connections</h4><p>After her own successful treatment for substance abuse at Long Beach Naval Hospital in California, Betty Ford set out to create what eventually became the Betty Ford Center. Mishek said the former first lady consulted with specialists at Hazelden to learn more about the <a href="http://archives.drugabuse.gov/ADAC/ADAC11.html" target="_blank">“Minnesota Model”</a> of 12-step-based substance-abuse treatment pioneered at the center. &nbsp;</p><p>“After Mrs. Ford went through treatment, she decided, ‘I’m going to give back. I am going to start a treatment center,’” Mishek said. “So she met with [former Hazelden president] <a href="http://www.hazelden.org/web/public/danielanderson.page" target="_blank">Dan Anderson</a> and studied what we were doing here. Then she went back to Rancho Mirage and opened her own center.” The Betty Ford Center was dedicated in 1982.</p><p>Over the decades, the two facilities remained closely connected, Mishek said. &nbsp;</p><p>“Dan Anderson would go out to Rancho Mirage here every winter for six weeks or a month and consult with Betty and work with the team,” Mishek said. “That’s part of the really strong relationship between the two organizations that allowed us to come together. Their clinical model and our clinical model were born of the same person.”</p><div class="image" style="margin-bottom: 20px;"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/McElrathFordAnderson640.jpg" alt="Damian McElrath, former First Lady Betty Ford and Dan Anderson" title="In 1982, former First Lady Betty Ford, center, met with Damian McElrath, Hazelden’s director of treatment services, left, and Dan Anderson, architect of the “Minnesota Model” of addiction treatment." /><div class="credit">Courtesy of Hazelden-Betty Ford</div><div class="caption">In 1982, former First Lady Betty Ford, center, met with Damian McElrath, Hazelden’s director of treatment services, left, and Dan Anderson, architect of the “Minnesota Model” of addiction treatment.</div></div><p>The rechristening of the Betty Ford Women’s Recovery Center ushers in a renewed focus on women and addiction at Hazelden, Mishek explained. Women battle addiction in equal numbers to men, but the gender breakdown of clientele at most treatment and recovery centers leans heavily toward male. &nbsp;&nbsp;</p><div style="width: 265px; float: right; padding: 16px; margin: 0 0 8px 16px; background-color: #c1bfc6;"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/mppresents250.png" alt="" /><h4>Health care equity: How do we get there?</h4><p>Addressing the biggest barriers to meaningful reduction in health-care disparities<br /><strong>Oct. 21 breakfast event at Northrop sponsored by UCare</strong></p><a href="http://www.eventbrite.com/e/health-care-equity-how-do-we-get-there-tickets-13318210125?ref=ebtnebregn" target="_blank"><img src="https://www.eventbrite.com/custombutton?eid=13318210125" alt="Eventbrite - Health Care Equity: How do we get there?" /></a></div><p>“The split between men and women at treatment centers is generally 60-40,” Mishek said. The former first lady saw the injustice in that equation, and insisted on equality at the facility that bore her name: “At the Betty Ford Center, Mrs. Ford said, ‘We are gong to have an equal number of beds for men and women,’ and they did.”&nbsp;</p><p>Mishek said that at Hazelden Betty Ford, they are working on ways to break down the barriers that many women often face when seeking treatment for addiction, including family responsibilities, financial pressures and lack of insurance coverage.&nbsp;</p><p>“Think about it like this,” Mishek said. “There’s a reason why most treatment centers have a 60-40 male-female split. It’s not because fewer women have addiction problems. It’s because it’s harder for them to get to treatment. We are trying to develop ways to make treatment more accessible for women.” Mrs. Ford would’ve wanted it that way.&nbsp;</p><div class="image"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/SusanFordBales640.jpg" alt="Susan Ford Bales" title="Susan Ford Bales addressing attendees of the rededication ceremony of the Betty Ford Women's Recovery Center on the Center City campus of Hazelden Betty Ford Foundation on October 10, 2014." /><div class="credit">Photo by Samantha Moy-Gottfried</div><div class="caption">Susan Ford Bales addressing attendees of the rededication ceremony of the Betty Ford Women's Recovery Center on the Center City campus of Hazelden Betty Ford Foundation on October 10, 2014.</div></div>http://www.minnpost.com/mental-health-addiction/2014/10/betty-was-women-hazelden-s-women-s-recovery-center-renamed-honor-for#commentsTwin CitiesWomen's Healthaddiction recoveryaddiction treatmentFri, 17 Oct 2014 13:18:15 +0000Andy Steiner89623 at http://www.minnpost.comHyde Amendment hurts low-income womenhttp://www.minnpost.com/community-voices/2014/09/hyde-amendment-hurts-low-income-women
<p>This week marks the 38<sup style="line-height: 1.5em;">th</sup>&nbsp;anniversary of Congress first passing the Hyde Amendment, which bars Medicaid from covering abortion care. This ban, enacted annually through the federal appropriations process, makes abortion unaffordable and often pushes it out of reach for women who are on Medicaid.</p><div class="image float-right"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/Melissa-headshot-150x150.jpg" alt="" title="Melissa Kwon" /><div class="credit"></div><div class="caption">Melissa Kwon</div></div><p>Just as disturbing as politicians’ willingness to interfere in personal decisions is the disproportionate impact the Hyde Amendment has on women of color. As an Asian American and Pacific Islander (AAPI) woman, I am very concerned about the impact that the Hyde Amendment continues to have on my AAPI community. Also, being a mother of a daughter in Minnesota, it has become even more personally important to me because I want to ensure that my daughter will grow up in a world where women have the right to make their own decisions about their bodies.</p><div class="float-left"><div class="minnpost-ads-ad minnpost-ads-ad-Middle "><script type="text/javascript">OAS_AD("Middle");</script></div></div><p>In the United States, 1 in 10 Asian Americans, 1 in 7 Native Hawaiians and Pacific Islanders, and 1 in 5 Southeast Asians are enrolled in Medicaid. These statistics are exacerbated in Minnesota, where there is the largest ratio of Southeast Asians (including Bhutanese, Burmese, Cambodian, Hmong, Karen, Laotian, Thai, and Vietnamese) among all states. Minnesota is home to the second largest Hmong population and third largest Lao population in the United States.&nbsp;</p><p>A large percentage of the AAPI community in Minnesota live below the poverty line, including 32 percent of Hmong, 28 percent of Laotian, 15 percent of Cambodian, and 12 percent of Vietnamese.&nbsp;Fortunately, in Minnesota, current Minnesota Medical Assistance covers abortion; however, it is constantly under attack in the state Legislature."&nbsp;&nbsp;</p><h4>Working to lift coverage bans</h4><p>The National Asian Pacific American Women’s Forum (NAPAWF) has been actively engaging the AAPI community in fighting to repeal the Hyde Amendment. NAPAWF is one of more than 60 partner organizations in the <a href="http://allaboveall.org/" target="_blank">All* Above All Campaign</a> building support for lifting abortion coverage bans.</p><p>Locally, the NAPAWF Twin Cities Chapter recently co-sponsored the All* Above All campaign’s Minneapolis stop on the Be Bold Road Trip, uniting people across the country to stand up against abortion coverage bans. Covering nearly 10,000 miles and visiting 12 cities in 8 states, the tour mobilized millennials, people of color, and other diverse groups to stand up to the avalanche of attempts to disenfranchise them and their reproductive health decision making. The chapter also sent two leaders to All* Above All’s Hill Education Day in Washington, D.C., earlier this month, where representatives from across the U.S. met with legislators in D.C. to tell them about the impact that the Hyde Amendment has on low-income women and women of color.</p><p>When it comes to the most important decisions in life, such as whether to become a parent, it is vital that a woman is able to consider all her options, including an abortion, regardless of her financial status. Instead of bans like the Hyde Amendment, it’s time for Congress to lift the restrictions on abortion coverage so women can make decisions based on what’s best for themselves.</p><p><em>Melissa Kwon, PhD, is the Reproductive Justice Leadership and Research Associate Director for the <a href="http://www.napawf.org" target="_blank">National Asian Pacific American Women’s Forum</a> (NAPAWF) and co-chair of the NAPAWF<a href="http://napawf.org/chapters/find-a-chapter/napawf-twin-cities-mn/" target="_blank"> Twin Cities Chapter</a>.</em></p><h5><b>WANT TO ADD YOUR VOICE?</b></h5><p>If you're interested in joining the discussion, add your voice to the Comment section below — or consider writing&nbsp;<a href="http://www.minnpost.com/submit-letter">a letter</a>&nbsp;or a longer-form&nbsp;<a href="http://www.minnpost.com/community-voices">Community Voices</a>&nbsp;commentary. (For more information about Community Voices, email&nbsp;<a href="http://www.minnpost.com/author/susan-albright">Susan Albright</a>&nbsp;at&nbsp;<a href="mailto:salbright@minnpost.com">salbright@minnpost.com</a>.)</p><p><strong>Correction:</strong> A previous version of this commentary misstated the relative ability of poor Minnesota women to get an abortion that is covered by insurance.&nbsp;</p>http://www.minnpost.com/community-voices/2014/09/hyde-amendment-hurts-low-income-women#commentsCongressWomen's Healthhealth careTue, 30 Sep 2014 10:00:00 +0000By Melissa Kwon89394 at http://www.minnpost.comSkirt size is a better predictor of breast cancer risk than body mass indexhttp://www.minnpost.com/second-opinion/2014/09/skirt-size-better-predictor-breast-cancer-risk-body-mass-index
<div class="image" style="margin-bottom: 20px;"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/BlueSkirt640.jpg" alt="Skirt size a better predictor of breast cancer risk than body mass index" title="At age 25, the average skirt size of the women in the study (as recalled and reported by them) was a U.S. 8 (U.K. 12)." /><div class="credit"><a href="https://www.flickr.com/photos/m1l4n/" target="_blank">Creative Commons/Milan Sijan</a></div><div class="caption">At age 25, the average skirt size of the women in the study (as recalled and reported by them) was a U.S. 8 (U.K. 12).</div></div><p>Here’s yet another reason to be concerned about <a target="_blank" href="http://www.minnpost.com/second-opinion/2014/09/americans-waistlines-keep-expanding-cdc-study-finds">our expanding waistlines</a>: A new <a target="_blank" href="http://bmjopen.bmj.com/content/4/9/e005400">study</a> has found that women who gain a skirt size each decade after their mid-20s are at increased risk of developing breast cancer after menopause.</p><p>In fact, this study’s findings suggest that skirt size is a better predictor of breast cancer risk than <a target="_blank" href="http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm">body mass index</a> (BMI).</p><p>For the study, which was published online this week in the journal <a target="_blank" href="http://bmjopen.bmj.com/site/about/">BMJ Open</a>, researchers analyzed three years of medical and lifestyle data collected from 93,000 women in England who were taking part in the <a target="_blank" href="http://www.cancerresearchuk.org/about-cancer/trials/a-study-looking-at-screening-the-general-population-for-ovarian-cancer">U.K. Collaborative Trial of Ovarian Cancer Screening</a>. Most of the women were white, had a university degree and lived in middle or upper socioeconomic areas. Most were also overweight at the start of the study, with an average BMI of 25-26. The average age at the start of the study was 64 — well past menopause.</p><p>During the period of the study, 1,090 women developed breast cancer, resulting in <a target="_blank" href="http://www.stats.org/faq_risk.htm">an absolute risk</a> of breast cancer of 1.2 percent. As would be expected from previous research, women who had a family history of breast or ovarian cancer or who had undergone infertility treatment or menopausal hormone therapy were at increased risk of being diagnosed with breast cancer, while those who had a history of being pregnant for at least six months were at decreased risk.</p><p>Yet, even after taking into account all those known risk factors, the study found that increases in skirt size emerged as the strongest predictor of breast cancer risk.</p><h4><b>A common experience</b></h4><p>Three out of four of the women in the study reported that their skirt size had increased since their mid-20s. At age 25, the average skirt size of the women in the study (as recalled and reported by them) was a U.S. 8 (U.K. 12). At the start of the study, the average skirt size reported by the women was a U.S. 10 (U.K. 14).</p><p>But many of the women acknowledged that their skirt size had jumped more than one size over those four decades or so. And when the researchers analyzed the data, they found that going up a skirt size every 10 years between the age of 20 and 64 increased the women’s risk of breast cancer later in life by 33 percent. Going up two skirt sizes every 10 years increased the risk even more, to 77 percent.</p><p>Of course, those are <a target="_blank" href="http://www.stats.org/faq_risk.htm">relative risks</a>. In absolute terms, an expansion in skirt size every 10 years increased the postmenopausal breast cancer risk from 1 in 61 to 1 in 51, the researchers explain. They also point out that putting BMI into the risk calculations did not significantly improve the prediction of risk. In other words, an increase in skirt size over a lifetime — not just skirt size at a particular point after menopause — was the better predictor of breast cancer risk.</p><p>The findings concur with other studies that have shown that an expanding midriff is associated with an increased risk of pancreatic, endometrial and ovarian cancer.</p><p>“Although the exact mechanisms of these relationships need to be better understood, there is a suggestion that body fat around the waist is more metabolically active than adipose [fat] tissue elsewhere,” the researchers write.</p><h4><b>Caveats</b></h4><p>Because this is <a target="_blank" href="http://www.cancer.gov/dictionary?cdrid=286105">an observational study</a> — and one that relied on people’s self-reporting of past and current skirt sizes — no definitive conclusions can be drawn about cause and effect. Another major limitation of the study is the homogeneity of the participants. The findings might have been different if the study had included more racially, ethnically and socioeconomically diverse women.</p><p>Furthermore, as almost every woman knows (but doesn’t like to admit), clothing manufacturers have been quietly engaging in “<a target="_self" href="http://en.wikipedia.org/wiki/Vanity_sizing">size inflation</a>” for decades in both the U.K. and the U.S. What was a U.S. size 12 in the 1980s or 1990s may now be a size 10 or 8, depending on the manufacturer.</p><p>The authors of this new study acknowledge such “vanity sizing,” but say it doesn’t affect their findings because the downsizing would have had an equal effect on the skirt-size reporting of all the women in their study — those who developed breast cancer and those who didn’t.</p><p>You can read the study in full <a target="_blank" href="http://bmjopen.bmj.com/content/4/9/e005400">on the BMJ Open website</a>.</p>http://www.minnpost.com/second-opinion/2014/09/skirt-size-better-predictor-breast-cancer-risk-body-mass-index#commentsWomen's Healthbreast cancerobesitywomen's healthFri, 26 Sep 2014 13:37:47 +0000Susan Perry89369 at http://www.minnpost.comGayarthri Ramprasad: Exercise, meditation and therapy help hold major depression at bayhttp://www.minnpost.com/mental-health-addiction/2014/09/gayarthri-ramprasad-exercise-meditation-and-therapy-help-hold-major-
<div class="image float-right"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/GayathriRamprasad225.jpg" alt="Gayarthri Ramprasad" title="Gayarthri Ramprasad" /><div class="caption">Gayarthri Ramprasad</div></div><p>For much of her life, author and mental health activist Gayarthri Ramprasad has struggled with depression. When she was a young woman growing up in a respected Brahmin family in Bangalore, India, a heavy, powerful feeling sometimes overtook her body and mind, leaving her unable to function.</p><p>But she had no way to describe what she was experiencing.</p><p>“Even today there is not one word that means ‘depression’ in the many Indian languages,” Ramprasad said. “How do you explain what you are experiencing when you don’t have a vocabulary to understand your pain?” This lack of openness about mental illness frustrated Ramprasad, who, for more than 30 years, has lived in Portland, Oregon, with her family. “At first I was ashamed,” she said, “But as I learned more about mental illness, I knew I had to speak openly about my disease in order to heal.”</p><p>When she discovered that antidepressant medications did not improve her mental state, Ramprasad set out to discover alternative therapies that helped alter her brain chemistry and lift her depression. She writes about her experience in her book <a href="http://gayathriramprasad.com" target="_blank">“Shadows in the Sun: Healing From Depression and Finding the Light Within<i style="font-size: 16px; line-height: 1.5em;">,</i>”</a> &nbsp;which was published earlier this year by Hazelden.</p><p>On Oct. 9 at 7 p.m., Ramprasad will be at St. Paul’s Fitzgerald theater as one of the featured guests on <a href="http://www.hazelden.org/web/public/event.view?eventId=4595634" target="_blank">“A Celebration of Women in Recovery,”</a> an event sponsored by the Hazelden Betty Ford Foundation and MPR’s Healthy States<i style="font-size: 16px; line-height: 1.5em;"> </i>initiative. The event, which will be moderated by writer and musician Dessa, will also feature blogger <a href="http://jennifermatesa.com" target="_blank">Jennifer Matesa</a>, whose book forthcoming “The Recovering Body: Physical and Spiritual Fitness for Living Clean and Sober,” will be published next year by Hazelden.</p><p>Ramprasad hopes that her book will spread a positive message for people living with mental illness. “There is hope and health,” she said. “People do recover from mental illness and go on to live completely functional, meaningful lives. Recovery is possible, no matter how bleak the situation.”</p><p>I spoke to Ramprasad from her home in Portland about living with depression, writing her book and the evolution of <a href="http://www.myasha.org" target="_blank">ASHA International</a>, the nonprofit she established in 2006 to educate the public about mental illness and support families struggling with its impact.</p><p><b style="font-size: 16px; line-height: 1.5em;">MinnPost</b>: <strong>What inspired you to write this book?</strong></p><p><b style="font-size: 16px; line-height: 1.5em;">Gayarthri Ramprasad</b>: My goal was to create a more understanding, compassionate world for my daughters and all of the daughters and sons of this world. As a people we have so many common threads that bind us. So many of us are focusing our energies wastefully on our differences —&nbsp;the differences of gender, race, sexuality, politics, mental health.</p><p>So much of the pain and suffering and loss is because we as people don’t take the time to stop and reflect and understand and embrace that we are one. What hurts me will eventually hurt you. It’s better that we stop and listen to on another and understand each other’s struggles and create a compassionate world where all existence thrives. To achieve that, part of us can’t be hurting. My hope is that this book will speak to people who struggle with mental illness, bring compassion and guidance to those who love them.</p><p><b style="font-size: 16px; line-height: 1.5em;">MP</b>: <strong>You have lived with depression for many years. When was that condition first diagnosed?</strong></p><p><b style="font-size: 16px; line-height: 1.5em;">GR</b>: Before I started this journey through mental illness, I was just another person in this world who was completely ignorant about mental health issues. So was my family.</p><p>I started struggling with depression when I was 18. We had no name for depression in India. Initially, I was called a difficult teenager. Then I was called weak and hypersensitive. Then I was a nervous bride. Then, when I left for America, I was called homesick. There was always a rationale, never a true understanding of what was causing my pain.</p><p>My journey was a horrific journey. My family paid a price. I paid a price. It wasn’t until we were in the throes of this disease not once but many times over that I started to learn the words that described my condition —&nbsp;and what I needed to do to survive.</p><p><b style="font-size: 16px; line-height: 1.5em;">MP</b><strong>: How did you get to that point?</strong></p><p><b style="font-size: 16px; line-height: 1.5em;">GR</b>: It is a long story. After the birth of my first daughter, I suffered from massive postpartum depression. My husband and I were living in the United States then, so I took my baby and went home to India, thinking that being with family might help me feel better. But it didn’t. In 15 days I lost 15 pounds. I was begging my parents to kill me.</p><p>Stigma and shame is pervasive in so many cultures when it comes to mental health. It was that way in India. My family didn’t want to talk about what was happening to me. I felt that the truth about my illness would shatter us for many generations to come. When you say, “mental illness,” back then, my image was that of a woman running down the street in Bangalore with dogs chasing her. I didn’t want to be that woman.</p><p>I started medications during the trip back home to India. I was also administered shock treatment and psychotherapy. My in-laws even summoned a priest to come home and get rid of the demons and he molested me. And when I came back to he United States, my mother came with me. I was in no shape to take care of myself — or my 18-month-old daughter.</p><p>Once back in the United States, I was connected to psychiatrists and therapists. Did the medications help? No. They only made me sicker. When medications fail, how does a person advocate for herself? I wish I had the strength then to understand what my soul knew.</p><p><b style="font-size: 16px; line-height: 1.5em;">MP</b><strong>: Since medications weren’t working for you, what was the next step?</strong></p><p><b style="font-size: 16px; line-height: 1.5em;">GR</b>: I struggled. It took a long time for me to even become aware, to educate myself about mental illness. That started one day when I was sitting in my therapist’s office. The day before, I had unsuccessfully tried to bury myself in my own back yard. I knew then that I needed to fight for my life.</p><p>My therapist said, “I care about you deeply but I can’t keep you alive by myself. Unless you educate yourself about your disease and how to manage it, you are not going to be able to stay alive for much longer.” She was right. I knew then that it was time for me to walk away from the shame and secrecy and the silence. I needed to step into the light and accept this diagnosis.</p><p>I chose that day to get hospitalized like my therapist was advising me. When I told my husband that I was going to be hospitalized, the first question he asked was, “What are we going to tell our friends?” I hated him at that point. If I had cancer, we wouldn’t have asked that. If I had heart disease he wouldn’t have asked that.</p><p>But with time and education about mental illness, we worked through those feelings. I still am married to the same man and happily so. Together we learned that we are not alone: There are 450 million others like me around the world who struggle with mental illness.</p><p><b style="font-size: 16px; line-height: 1.5em;">MP</b><strong>: How did you learn about the alternative therapies you now practice?</strong></p><p><b style="font-size: 16px; line-height: 1.5em;">GR</b>: When I first came to the United States, I watched the show “Family Ties," and I fell in love with Michael J. Fox. When I was in the hospital going through all this trauma, there was an intern who looked like Michael J. Fox. He made my heart flutter.</p><p>One day, he asked if I had ever tried transcendental meditation.</p><p>There’s a Buddhist proverb that says, “The teacher appears when the student is ready.” I was ready to do anything to save myself. I said, “Tell me more.”</p><p>I have practiced transcendental meditation for 25 years now, every morning of my life. It has completely transformed me. Slowly, I discovered that combining meditation with cognitive behavioral therapy and exercise, especially yoga, is effective in fighting my depression. It is an irony that I have to come from a country where two of these skills originated and I had to come halfway around the world to learn that these work in treating my illness.</p><p>Before, I thought the only way to fight mental illness was “meds and therapy, meds and therapy.” Medication works for many people around the world, but what happens when it doesn’t work? I discovered that even when meds don’t work there are so many paths to wellness. I like to say that India gave me roots. America has given me wings to fly. I am truly lucky to have these two mothers.</p><p><b style="font-size: 16px; line-height: 1.5em;">MP</b><strong>: Do these practices work for you 100 percent of the time?</strong></p><p><b></b><b style="font-size: 16px; line-height: 1.5em;">GR</b>: I still do struggle with recurrent bouts of depression. I compare it to a storm. When it hits me it knocks me down to my knees.</p><p>But now I’ve got my own wellness plan, which, when the tsunami strikes and gets me down to my knees, will help me get up again. That I think is the ultimate freedom. No matter what the darkness I know I have the light within me.</p><p><b style="font-size: 16px; line-height: 1.5em;">MP</b><strong>: Are you opposed to anyone using medications to treat mental illness?</strong></p><p><b></b><b style="font-size: 16px; line-height: 1.5em;">GR</b>: Not at all. My own brother successfully treats his mental illness with medication.</p><p>I want to get this message clear: Every person has his or her own path to wellness. My message is that even when medications work, the holistic practices I teach have universally been shown to be helpful.</p><p>These practices are not just useful for mental health and addiction. It is helpful for anyone’s health and wellness. Let’s teach our children ways of living well every day so we don’t have to get sick in the first place. When we get sick, those very same practices are going to empower us to be that much more resilient in bouncing back.</p><p>There is not health without mental health. These practices can help everybody live better lives.&nbsp;</p>http://www.minnpost.com/mental-health-addiction/2014/09/gayarthri-ramprasad-exercise-meditation-and-therapy-help-hold-major-#commentsWomen's HealthWed, 24 Sep 2014 13:05:43 +0000Andy Steiner89325 at http://www.minnpost.com1 in 5 U.S. women raped during their lifetimes, CDC study findshttp://www.minnpost.com/second-opinion/2014/09/1-5-us-women-raped-during-their-lifetimes-cdc-study-finds
<p>One in five women in the United States — more than 23 million in all — have been raped during their lifetimes, and almost half of all women have experienced some other form of sexual violence, such as sexual coercion or unwanted sexual contact, according to <a target="_blank" href="http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm">a new report</a> released Friday by the <a target="_blank" href="http://www.cdc.gov/">Centers for Disease Control and Prevention</a> (CDC).</p><p>For men the numbers are much lower, but still troubling: An estimated 1.7 percent of men (almost 2 million) have been raped during their lifetimes, and almost one quarter have been victims of other forms of sexual violence, the report found.</p><p>“Although progress has been made in efforts to prevent sexual violence, stalking, and intimate partner violence, these forms of violence continue to exact a substantial toll upon U.S. adults,” the authors of the study write.</p><p>The findings are the result of almost 13,000 landline and cell phone interviews conducted by CDC researchers between January and December 2011.</p><p>This study adds credence to a <a target="_blank" href="https://www.ncjrs.gov/app/publications/abstract.aspx?ID=243011">2007 campus sexual assault survey</a> commissioned by the U.S. Department of Justice in which one in five undergraduate women reported being sexually assaulted since entering college. Critics of that study — mostly pundits on the political right — claimed its results were not valid because the survey included only 5,500 women from two colleges.</p><p>The CDC study's finding is also consistent with <a target="_blank" href="%20http://www.unicef.org/publications/files/Hidden_in_plain_sight_statistical_analysis_EN_3_Sept_2014.pdf">a UNICEF report</a> published last Thursday that suggests 1 in 10 girls worldwide &nbsp;— or about 120 million in total — is raped or otherwise sexually abused before age 18.</p><p>In the CDC study, 54 percent of the women and 48 percent of the men who had experienced rape or other form of sexual violence said the incident had occurred before they were 25 years old. Among female victims of rape, almost 80 percent said they were first raped before the age of 25, and 40 percent were first raped before the age of 18.</p><h4><b>Main findings</b></h4><p>Other key findings in the CDC study include the following:</p><ul><li>Sexual violence affects a significant proportion of women of all races and ethnicities. For example, the estimates for women who were raped during their lifetimes broke down like this: 32.3 percent of multiracial women, 27.5 percent of American Indian/Alaska Native women, 21.2 percent of non-Hispanic black women, 20.5 percent of non-Hispanic white women and 13.3 percent of Hispanic women.</li></ul><ul><li>The lifetime estimates of rape for men by race or ethnicity were not statistically reliable, the CDC researchers note, with one exception: an estimated 1.6 percent of non-Hispanic white men were raped during their lifetimes.</li></ul><ul><li>Almost 2 percent of the women surveyed — representing about 1.9 million women — said they had been raped within the previous 12 months.</li></ul><ul><li>The vast majority of rapists are men. Among the people in the survey who had been raped, 99 percent of the women and almost 80 percent of the men said their rapists had been men. Women, however, were often the perpetrators of other forms of sexual violence against men. For example, among the men in the survey who said they had experienced unwanted sexual contact, 54.7 percent said the contact had come from women.</li></ul><ul><li>Most of the victims of sexual violence — men and women — know their perpetrators. Of the people in the CDC study who had been raped, 46.7 percent of the women and 44.9 percent of the men said their rapist was an acquaintance, and 45.4 percent of the women and 29 percent of the men said their rapist was an intimate partner. &nbsp;</li></ul><h4>Early prevention needed</h4><p>This survey has its limitations, of course. Most notably, the response rate was only 33 percent. But those who did participate in the survey were highly cooperative, the CDC researchers point out, and several steps were taken to reduce any bias resulting from people not responding.</p><p>“Because a substantial proportion of sexual violence, stalking, and intimate partner violence is experienced at a young age, primary prevention of these forms of violence must begin early,” the CDC researchers conclude.</p><p>Prevention needs to focus “on the promotion of healthy relationship behaviors and other protective factors, with the goal of helping adolescents develop these positive behaviors before their first relationships,” they add. “The early promotion of healthy relationships while behaviors are still relatively modifiable makes it more likely that young persons can avoid violence in their relationships.”</p><p>The report <a target="_blank" href="http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm">was published</a> in the Sept. 5 issue of Morbidity and Mortality Weekly Report (MMWR), a CDC publication.</p>http://www.minnpost.com/second-opinion/2014/09/1-5-us-women-raped-during-their-lifetimes-cdc-study-finds#commentsNationWomen's HealthCenters for Disease Control and PreventionHealthsexual abusesexual assaultMon, 08 Sep 2014 15:26:51 +0000Susan Perry89116 at http://www.minnpost.comToo many women lack full access to affordable reproductive health carehttp://www.minnpost.com/community-voices/2014/08/too-many-women-lack-full-access-affordable-reproductive-health-care
<div class="image float-right"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/rev-kelli-clement.png" alt="" title="By Rev. Kelli Clement" /><div class="credit"></div><div class="caption">By Rev. Kelli Clement</div></div><p>Vacationing in my Texas hometown last week, I helped my folks clean out a storage closet. We went through boxes of photos, old journals, markers of times gone by. Reading one of my journals, I revisited the most challenging period of my life: I was barely scraping by, working two jobs, in the grip of substance abuse, and in an unhealthy relationship. The worn blue notebook contained the story of my abortion in Dallas some 30 years ago. In a single visit to an independent clinic, I was able to get the care I needed, from courageous and compassionate staff, but only after running a gantlet of shouting protesters telling me that I was going to hell.</p><p>It was a difficult experience, and my feelings in the days after the procedure yo-yoed back and forth between grief and relief. I have never regretted this most intimate health care decision, not then nor at any time since those bleak days. As a person of faith, I knew it was the right decision for me and my family, and I knew I was lucky. Even though I did not have health insurance, I had a safety net, and I was able to have the procedure early in my pregnancy, when it was safest and most affordable.</p><p>This is a story of privilege. Because of the Hyde Amendment, which bars federal funds from being used for abortion care, women who receive their health care from Medicaid are not so lucky. Nearly 1 in 3 women who experience unintended pregnancy will have an abortion, and nearly 80 percent of them live at or below the poverty line. Most already have children; they know what it means to make difficult parenting decisions.</p><p>This issue speaks to the very heart of justice for us at the <a href="http://www.mnrcrc.org/" target="_blank">Minnesota Religious Coalition for Reproductive Choice</a>. We represent a broad cross-section of faith communities who believe that a woman, no matter what her economic circumstances, should have access to safe and dignified reproductive health care. We believe that a woman facing an unintended pregnancy is best suited to make decisions for herself and her family, without political interference. We believe that God gives each of us, in consultation with our faith and with those who matter most to us, the ability to determine our capacity for parenting, for caring for others in our families, for serving our communities.</p><div class="float-left"><div class="minnpost-ads-ad minnpost-ads-ad-Middle "><script type="text/javascript">OAS_AD("Middle");</script></div></div><h4>Biblical guidance</h4><p>Scripture upon scripture in both the Hebrew and Christian books of the Bible call the faithful to care for those in poverty, those who struggle to make ends meet, the downtrodden and heavy laden. We know that a woman in Minnesota facing an unwanted pregnancy may miss paying her rent or buying groceries for her family in order to pay for the abortion she needs and wants.</p><p>People of faith may have different views on reproductive health, rights, and justice, but we should be able to agree that a woman facing a difficult situation deserves compassion and access to a full spectrum of reproductive health care, rather than judgment, shame and denial of basic services. At MNRCRC, we say the political gamesmanship in which low-income women are used as pawns is morally wrong.</p><h4>Religious liberty</h4><p>We understand religious liberty to mean that each of us has the constitutionally protected right to make our own health care decisions according to our own faith and conscience.</p><p>There is no right to inflict spiritual or emotional harassment, no matter how strongly others feel about their own beliefs. Nor should there be a right to deny basic reproductive health care to any woman, regardless of whether her insurance is public or private. God calls us to address the racial and economic injustices of the Hyde Amendment: low-income women, women of color, young women, Native American women, and immigrant women are unfairly discriminated against by federal abortion funding bans. While abortion remains legal under Roe v. Wade, far too many women have no access because of funding bans and other intrusive and medically unnecessary restrictions.</p><h4>Repeal Hyde Amendment</h4><p>MNRCRC is proud to join with the All* Above All campaign to raise awareness and build support for the repeal of the punitive Hyde Amendment. When the Be Bold Road Tour pulled into the Twin Cities on Tuesday, we were there, as a faithful witness for reproductive justice. Check the <a href="http://www.allaboveall.org" target="_blank">website</a>&nbsp;for more details.</p><p>The decision of when and whether to parent a child is complicated, one of the most crucial decisions any of us will ever make. I have always been grateful that I had the means and the access to follow my own conscience regarding the outcome of that pregnancy long ago. Today I am the mother, wife, daughter, friend, community member and clergy person God calls me to be, and my life is better because I had the access and means to have a safe, legal, affordable abortion. Every woman deserves the same, regardless of how she gets her insurance.</p><p><i style="font-size: 16px; line-height: 1.5em;">The Rev. Kelli Clement is a Unitarian Universalist Community minister in Minneapolis. She is a member of the Center for American Progress Faith and Reproductive Justice Leadership Institute. She serves as executive director of the Minnesota Religious Coalition for Reproductive Choice, now in its 25<sup>th</sup> year of service, education and advocacy.</i></p><h5><b>WANT TO ADD YOUR VOICE?</b></h5><p>If you're interested in joining the discussion, add your voice to the Comment section below — or consider writing&nbsp;<a href="http://www.minnpost.com/submit-letter">a letter</a>&nbsp;or a longer-form&nbsp;<a href="http://www.minnpost.com/community-voices">Community Voices</a>&nbsp;commentary. (For more information about Community Voices, email&nbsp;<a href="http://www.minnpost.com/author/susan-albright">Susan Albright</a>&nbsp;at&nbsp;<a href="mailto:salbright@minnpost.com">salbright@minnpost.com</a>.)</p>http://www.minnpost.com/community-voices/2014/08/too-many-women-lack-full-access-affordable-reproductive-health-care#commentsCongressWomen's HealthHealthThu, 28 Aug 2014 10:00:00 +0000By Rev. Kelli Clement89005 at http://www.minnpost.comHobby Lobby ruling gives impetus to Lizz Winstead's Lady Parts Justice efforthttp://www.minnpost.com/politics-policy/2014/07/hobby-lobby-ruling-gives-impetus-lizz-winsteads-lady-parts-justice-effort
<p>When the U.S. Supreme Court decided that some employers have the right to deny health care based on religious beliefs last week, <a href="https://twitter.com/lizzwinstead" target="_blank">Lizz Winstead</a>&nbsp;and her comrades in <a href="http://ladypartsjustice.com/" target="_blank">Lady Parts Justice</a>&nbsp;were ready. The website’s official launch doesn’t happen until July 15, but Winstead’s Brooklyn-based crew posted <a href="https://www.youtube.com/watch?list=PLmLCHQC4Nm-QY9YMSebUKAxt9d99GXSQI&amp;v=kKjVBQxlhRs" target="_blank">this video</a>, which went viral amid the initial outrage last Monday, and it hasn’t stopped reverberating yet:</p><p><iframe frameborder="0" height="360" src="//www.youtube.com/embed/kKjVBQxlhRs?list=PLmLCHQC4Nm-QY9YMSebUKAxt9d99GXSQI" width="640"></iframe></p><p>“In 2014 alone, there’s been over 700 pieces of legislation proposed to curb some kind of reproductive health,” said Winstead from her home office in New York on the 4<sup style="line-height: 1.5em;">th</sup> of July. “Thirty-one states, including Minnesota, allow a rapist to sue for custody if a pregnancy occurs from a rape. This is the world we live in. What discourages me is how much of this is coming down. What profoundly encourages me is when people find out about it they want to join up and they’re outraged and they really like <a href="http://blogs.villagevoice.com/runninscared/2013/11/abortion_lizz_winstead_sarah_silverman_texas_women_forever_wendy_davis.php" target="_blank">using humor and using language that is raw and funny and not appropriate</a>&nbsp;to get the message out.” <a href="http://blogs.villagevoice.com/runninscared/2013/11/abortion_lizz_winstead_sarah_silverman_texas_women_forever_wendy_davis.php" style="font-size: 16px; line-height: 1.5em;"><br /></a></p><p>At the moment the message is that the <a href="https://www.aclu.org/blog/tag/war-women" target="_blank">War on Women</a>&nbsp;is being lost, but that it has a fighting chance with thought leaders like Winstead, who has long championed women’s reproductive health rights, from her days supporting <a href="http://en.wikipedia.org/wiki/Rock_for_Choice" target="_blank">Rock For Choice&nbsp;</a>benefits in her hometown of Minneapolis to the last two years of her life, which have been spent <a href="http://austin.culturemap.com/news/city-life/06-19-12-18-17-daily-show-co-creator-lizz-winstead-takes-a-stand-for-planned-parenthood-in-austin/" target="_blank">organizing and performing benefits for Planned Parenthood and independent clinics</a>. <a href="http://austin.culturemap.com/news/city-life/06-19-12-18-17-daily-show-co-creator-lizz-winstead-takes-a-stand-for-planned-parenthood-in-austin/" style="font-size: 16px; line-height: 1.5em;"><br /></a></p><p>“Right now I’m the face, but I’m not a one-woman band,” she said. “There’s a team of people that has come together who understand the profundity of what’s happening and who can’t imagine doing anything else. No one is pushing the boundaries like we are, and I think it’s OK to make people mad. There’s people who think you should never enter humor into this arena, and then there’s people like me who say, ‘This arena is called health care. This arena is not called religion.’ And I don’t shy away from the word abortion, and I don’t fall on the shame sword because I had an abortion.</p><div class="image float-right"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/LizzWinsteadLPJ225.jpg" alt="Lizz Winstead" title="Lizz Winstead" /><div class="credit">Photo by Michael Young</div><div class="caption">Lizz Winstead</div></div><p>“We’re just one little tiny organization trying to reinvent what it means to celebrate ourselves. We’re saying, ‘We’re cool, we’re awesome, we’re the ones who want to have super fun righteous sex and we don’t necessarily want to have your kid. How did we become the bad guys of the sexual revolution again?’ ”</p><p>The July 15 website launch is the first order of business for Lady Parts Justice, followed by the <a href="http://twitchy.com/2014/04/14/lady-parts-justice-to-create-v-to-shining-v-national-pride-day-for-women/" target="_blank">Sept. 27 planned call-to-arms “V To Shining V,”</a> in which pro-choice people across the country are being asked to come together to organize and rabble-rouse about the state of women’s reproductive freedoms.</p><p>“What we really want people to do is not unlike what <a href="http://mnunited.org/" target="_blank">Minnesotans United for All Families</a>&nbsp;did with their house parties,” said Winstead. “We’re encouraging a national day of house parties and block parties in bars or your house. Invite people over, drink, celebrate, talk about what’s happening. We’re going to send you a kit that has a game in it and tattoos and all this fun stuff. Parties will be throughout the day, with the focus being on talking about what’s on the ballot and reminding people what’s at stake in the midterms.</p><div class="image float-left"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/LadyPartsJusticeLogo220.png" alt="" /></div><p>“I’ll be damned if I’m going to let the media tell me people aren’t going to be out to vote. Ten million more women than men voted in the last election, and we have to keep that momentum going. Sept. 27 is a day for people to get together and say, ‘You know, between now and the midterm elections, we’re going to make a pledge to get people out to vote and talk about how [screwed] up it is in the states.’”</p><p>Between now and then and however long it takes, Lady Parts Justice will be at the forefront of the fight.</p><p>“It feels really good,” said Winstead of her team’s most recent work. “We want to get people psyched. We’re all exhausted, but we feel like we’re doing work that matters and just the teaser videos that we’ve been putting out have been received very well. People have been loving it.”</p>http://www.minnpost.com/politics-policy/2014/07/hobby-lobby-ruling-gives-impetus-lizz-winsteads-lady-parts-justice-effort#commentsWomen's HealthHealthTue, 08 Jul 2014 13:13:55 +0000Jim Walsh88347 at http://www.minnpost.comHow does the Supreme Court nullify thee? Let us count the wayshttp://www.minnpost.com/community-voices/2014/07/how-does-supreme-court-nullify-thee-let-us-count-ways
<div class="image" style="margin-bottom: 10px;"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/14059735148_90210f5ef3_z.jpg" alt="" title="In the name of religion, the court majority granted owners of for-profit corporations special rights to deprive their employees of basic health care." /><div class="credit"><a href="https://www.flickr.com/photos/taedc/14059735148/" target="_blank">CC/Flickr/Ted Eytan</a></div><div class="caption">In the name of religion, the court majority granted owners of for-profit corporations special rights to deprive their employees of basic health care.</div></div><p>In the Hobby Lobby opinion read by Justice Samuel Alito, the U.S. Supreme Court majority showed itself to be elitist, patriarchal, and partial to religious views that mirror its own. In the name of religion, the court majority granted owners of for-profit corporations special rights to deprive their employees of basic health care.&nbsp;</p><p>With apologies to Elizabeth Barrett Browning, the takeaway for employees seems to be, “How does the court nullify thee?&nbsp;Let me count the ways.”</p><p><b>1.&nbsp;Corporations are deemed to be people.</b></p><p>In the spirit of the “Citizens’ United” opinion of 2010, which gave corporations First Amendment rights for the purpose of political contributions, Alito wrote for Hobby Lobby, “Protecting the free-exercise rights of closely held corporations thus protects the religious liberty of the humans who own and control them.”&nbsp;That such protection allows corporate heads to trample on the rights of the flesh and blood people they employ was not mentioned. For Hobby Lobby, 13,000 employees with their own ideas on health care and religion are affected.<b></b></p><p><b>2. Corporations get to have their cake and eat it, too.</b></p><p>We little people might wonder why the people who create corporations get to be protected as neutral legal entities separate from themselves when it suits them (legal liability) and yet also are able to control the most intimate parts of their employees’ lives under the guise of “sincere” religious belief.&nbsp;After all, such sincerity would be clear religious intolerance (discrimination) if attributed to neutral for-profit corporations. &nbsp;<b></b></p><p><b>3. Closely held corporations get special treatment because families own them.</b></p><div class="image float-right"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/JaneAhlin225.jpg" alt="Jane Ahlin" title="Jane Ahlin" /><div class="credit">Courtesy of Jane Ahlin</div><div class="caption">Jane Ahlin</div></div><p>Alito spoke as if closely held corporations were a few special cases singled out for exemption instead of the vast majority of corporate interests. In truth, about 90 percent of corporations are closely held. Many are huge. As Justice Ruth Ginsberg pointed out in a footnote to her dissent, “Mars Inc. [the candy company], with 72,000 employees and $33 billion in revenue, and Cargill Inc., with 140,000 employees and $136 billion in revenue,” are closely held companies.</p><p><b>4. The government can pick up the bill for corporations.</b></p><p>Alito insisted the employees of Hobby Lobby wouldn’t be burdened because government can pay for health care benefits corporations object to the same way it does already for actual religious organizations. He is A-OK with taxpayers picking up the insurance tab for for-profit corporations in the name of religious freedom.</p><p><b>5. Corporations never will object to anything on religious grounds other than contraceptives. </b></p><p>Alito and his four cohorts — all middle-aged or senior Roman Catholic males — deny that they are setting precedent for corporate religious objections of all kinds and scoff at the notion that there will be lawsuits about vaccinations or psychiatric care or Sharia dictums.</p><p>Of course to be as intrusive as Hobby Lobby is into women’s lives (interfering in the privacy of doctor-patient decisions and even contraceptive choices for spousal lovemaking) it would have to be something along the lines of orthodox Jewish factory owners insisting that male workers prove they’re circumcised.</p><p>Much more likely are the religious objections corporations will claim toward people who are lesbian, gay, bisexual, or transgender.&nbsp;</p><p><b>6. The Supreme Court knows sincerity when it sees it; scientific facts don’t matter. &nbsp;</b></p><p>The court majority doesn’t say how “sincere” corporations will be sorted out from the opportunistic. Certainly, they don’t care that Hobby Lobby’s investments include pharmaceutical firms making both the contraceptives objected to in court and outright abortion drugs. Plus, Hobby Lobby buys from China where abortion is state policy. The court majority also dismissed scientific studies showing Hobby Lobby’s objected-to contraceptives do not actually cause abortion.</p><p><b>7.&nbsp;Although the ruling affects only women, the opinion isn’t gender-biased. </b></p><p>Because 99 percent of women use contraception as basic health care during their reproductive years, there would be no case without gender.</p><p>Cases about “religious freedom” are really cases about sex and who has the power to control it in society. Justices in the current court majority prefer corporations;&nbsp;they do not trust the people.</p><p><em>A writer and columnist from Fargo, N.D., Jane Ahlin also has taught English at Minnesota State University Moorhead.</em></p><h5 style="font-size: 16px;"><b>WANT TO ADD YOUR VOICE?</b></h5><p>If you're interested in joining the discussion, add your voice to the Comment section below — or consider writing&nbsp;<a href="http://www.minnpost.com/submit-letter">a letter</a>&nbsp;or a longer-form&nbsp;<a href="http://www.minnpost.com/community-voices">Community Voices</a>&nbsp;commentary. (For more information about Community Voices, email&nbsp;<a href="http://www.minnpost.com/author/susan-albright">Susan Albright</a>&nbsp;at&nbsp;<a href="mailto:salbright@minnpost.com">salbright@minnpost.com</a>.)</p>http://www.minnpost.com/community-voices/2014/07/how-does-supreme-court-nullify-thee-let-us-count-ways#commentsWomen's HealthAbortioncontraceptionHobby LobbySonia SotomayorU.S. Supreme Courtwomen's healthwomen's rightsMon, 07 Jul 2014 10:00:00 +0000Jane Ahlin88322 at http://www.minnpost.comPost-Hobby Lobby, how will affected women get contraception coverage?http://www.minnpost.com/dc-dispatches/2014/07/post-hobby-lobby-how-will-affected-women-get-contraception-coverage
<p class="Bylineinfo">WASHINGTON — The immediate political reaction to the Supreme Court’s Hobby Lobby decision Monday was as you’d expect: Republicans like Rep. Michele Bachmann praised the ruling as a win for religious liberties, while Democrats from Sen. Al Franken on down slammed it as anti-women’s health.</p><p class="Bylineinfo">The decision gave religiously minded private business owners an out if they object to providing contraception coverage under company health insurance plans. But it also suggested different ways regulators or lawmakers could provide coverage for contraception to affected women.</p><p class="Bylineinfo">The question right now is how that might happen.</p><p class="Bylineinfo">The court offered up a few ideas of its own. <a href="http://www.supremecourt.gov/opinions/13pdf/13-354_olp1.pdf">Writing for the court in a 5-4 decision</a> [PDF], Justice Samuel Alito said the government could take up the task of paying for contraception coverage, or regulators could carve out an exemption for closely held companies like it did for religious nonprofits last year. Under that exemption, health care plans provide contraception to their beneficiaries at no cost to the companies offering the plans.</p><p align="left">White House spokesman Josh Earnest said Monday that President Obama, while opposing the court’s ruling, would prefer asking Congress to write a legislative response.</p><p align="left">“It is our view that Congress needs to take action to solve this problem that’s been created, and the administration stands ready to work with them to do so,” Earnest said.</p><p align="left">That’s an unlikely path forward, though, especially if the administration hopes to follow the government-funded contraception route. Given that most Republicans still oppose the health care law, it’s hard to imagine the GOP-controlled House signing off on an Obamacare expansion. And, as Alito noted in his opinion, no one knows what the final cost will be, since the government hasn’t even calculated how many women will be lacking contraception coverage post-Hobby Lobby.</p><p align="left">Dorsey and Whitney health care lawyer Tim Goodman said it’s unlikely the administration would try expanding government-funded contraception on its own.</p><p class="Bylineinfo">“I’m not sure how far agencies think they can go,” he said. “Any time there’s a cost you have to get that funded by Congress.”</p><p align="left">But combine new Obamacare regulations with a still unknown price point, and add the fact there are a dwindling number of congressional work days between now and November’s elections, and there’s next to no chance lawmakers will move forward with a legislative response any time soon.</p><h4 align="left">Administration could rewrite regulations</h4><p align="left">With Congress out of the picture, that probably leaves some type of administrative fix.</p><p class="Bylineinfo"><a href="http://www.buzzfeed.com/chrisgeidner/white-house-response-to-hobby-lobby-ruling-could-be-simply-t">Legal analysts suggested Monday</a> that the Obama administration could rewrite contraception regulations for companies affected by Hobby Lobby on its own, and relatively quickly, and the court seemed not to mind a rewrite of the rules, either.</p><p align="left">“HHS [Health and Human Services] itself has demonstrated that it has at its disposal an approach that is less restrictive than requiring employers to fund contraceptive methods that violate their religious beliefs,” Alito wrote. “HHS has already established an accommodation for nonprofit organizations with religious objections.”</p><p align="left">Last year, the administration released rules allowing religious nonprofits to opt out of paying for contraceptive coverage through their health care plans. The nonprofit’s health care provider would then provide the coverage on its own, at no additional cost to employees.</p><p align="left">It took the government more than three years to write that regulation, but Goodman said regulators could theoretically have the new rules finalized as soon as the end of the year.</p><p class="Bylineinfo">“If the agencies decided that might be the correct approach to apply more broadly, they already have the framework in place,” he said.</p><p align="left">Of course, depending on how the exemption is administered, it could run into legal challenges of its own. A nonprofit from Colorado challenged the mechanism by which it applies for the exemption last year, arguing that the paperwork required to apply for the exemption makes it “a party to the mandate.”</p><h4 align="left">Congressional response</h4><p align="left">Many legal analysts have said Monday's court ruling has a relatively narrow practical impact. It affects only closely held (usually family-owned) companies who object to offering employees contraception on religious grounds. Hobby Lobby's complaint also dealt with just four of the 20 contraceptive methods mandated for coverage under the ACA. The court dismissed —&nbsp;at least for now —&nbsp; potential religious objections to other coverage mandates such as vaccinations or blood transfusions, though Goodman said the ruling will probably mean eventual challenges to those mandates as well.</p><p align="left">In a statement after the decision, Bachmann said he was “extremely encouraged” by the court’s decision.</p><p align="left">“At its core, today’s decision was about the right of individual and family business owners to be free from government mandates that force them to deny their sincerely-held religious beliefs,” she said. “America was founded on the principle of religious freedom, and there is nothing more fundamental than the First Amendment.”</p><p align="left">Franken, who is up for re-election this year, said he was “very disappointed” in the decision and said, “A woman’s boss should never be the one to make health care decisions for her — these decisions should be between a woman and her doctor.”</p><p align="left">Rep. Betty McCollum called it “an attack on the rights of women and sets a dangerous new standard for corporate personhood.”</p><h4 align="left">Precedent for other cases</h4><p align="left">Hobby Lobby will serve as precedent for <a href="http://www.motherjones.com/politics/2014/04/hobby-lobby-sebelius-contraceptive-for-profit-lawsuits#cases">scores of lawsuits nationally</a> against the contraception mandate, including several from Minnesota.&nbsp;</p><p align="left">“This a big victory for sincere religious objectors to the HHS mandate,” said Erick Kaardal, a Minneapolis attorney representing seven different companies in their lawsuits.</p><p align="left">Kaardal’s clients included companies ranging from manufacturers to investment firms with workforces from 10 to 70 employees, all of which are closely held companies run by Catholics. All of the cases —&nbsp;including one from Minnetonka-based Annex Medical, <a href="http://www.startribune.com/local/229154211.html#ffDfOWPgErLREXRU.97">which argued against the mandate in a federal court in October</a> — will be analyzed and decided in the context of the Hobby Lobby decision.&nbsp;</p><p align="left">Kaardal couldn't say how his clients would react to a new contraception coverage program like the nonprofit exemption — their concerns over the contraception mandate are guided more by the Catholic church's teaching rather than the nuances of health care policy, he said.&nbsp;</p><p align="left">Either way, “the little people won this time,” he said. “For very, very few people, this is a really important decision.”</p><p class="Bylineinfo"><i>Devin Henry can be reached at <a href="mailto:dhenry@minnpost.com">dhenry@minnpost.com</a>. Follow him on Twitter: <a href="https://twitter.com/dhenry">@dhenry</a></i></p>http://www.minnpost.com/dc-dispatches/2014/07/post-hobby-lobby-how-will-affected-women-get-contraception-coverage#commentsBarack ObamaCongressNationCourtsWashington BureauMichele BachmannPoliticsWomen's HealthAffordable Care ActAl FrankenBetty McCollumhealth carehealth care reformTue, 01 Jul 2014 14:56:14 +0000Devin Henry88278 at http://www.minnpost.comBreastpumping moms gain new rights — but does Minnesota's new ‘Women’s Security’ law have enough teeth?http://www.minnpost.com/health/2014/06/breastpumping-moms-gain-new-rights-does-minnesotas-new-women-s-security-law-have-enou
<p class="FreeFormA">"I work at Mcdonalds, and have no idea how i'm supposed to pump at work."</p><p class="FreeFormA">That was the title of <a href="http://www.reddit.com/r/breastfeeding/comments/21dkxa/i_work_at_mcdonalds_and_have_no_idea_how_im/" style="line-height: 1.5em;" target="_blank">a forum post</a> by Minnesota Reddit user ziggyllama two months ago — or a month before Governor Dayton signed the <a href="https://www.revisor.mn.gov/bills/text.php?number=HF2536&amp;session=ls88&amp;version=list&amp;session_number=0&amp;session_year=2014" style="line-height: 1.5em;" target="_blank">Women's Economic Security Act</a>.&nbsp;</p><p class="FreeFormA">Ziggyllama continued [sic]: "I'm just really worried, i love breastfeeding, and i don't want to give my baby formula. I really don't want my milk supply to get low just because people want to order some burgers and the managers aren't letting me pump. We also don't have a single area i can think of to pump. No where has a door! The office is out in the open, and the break room. I could go into the linnen closet, but i don't think it has a plug in."</p><p class="FreeFormA">Any new mother who’s returned to work and continued nursing — no matter where she falls on the professional spectrum — will sympathize with the poster's anguish and stress. Even the best available workplace situations are filled with stories of breastpumping embarrassment and frustration.</p><p class="FreeFormA">Minnesota has long compelled employers to make provisions for employees to pump in the workplace; the 2010 <a href="http://www.hhs.gov/healthcare/rights/" target="_blank">Affordable Care Act</a> contained similar federal requirements.</p><p class="FreeFormA">But WESA goes further, adding that the area supplied for expressing breast milk be "shielded from view and free from intrusion from coworkers and the public and that includes access to an electrical outlet."&nbsp;</p><p class="FreeFormA">Furthermore, the new act expands the old statute to ban employers — meaning "a person or entity that employs one or more employees" — from retaliating against an employee who asserts her rights.</p><p class="FreeFormA">Still, a law that looks great on politicians' resumes might leave working mothers wanting. Its requirements sound specific and reasonable, there is one giant flaw.</p><p class="FreeFormA">"Very few states, including Minnesota, provide for penalties for non-compliance — which weakens these kinds of statutes since there’s not much risk to failing to comply," said Marcia McCoy, treasurer of the <a href="http://mnbreastfeedingcoalition.org" target="_blank">Minnesota Breastfeeding Coalition</a>.</p><p class="FreeFormA">A Minnesota Department of Labor and Industry (DLI) representative said WESA has expanded the agency's authority. In the past, DLI responded to workplace lactation law complaints with an "inform-and-educate process," but the expanded law will allow the agency to "investigate and issue orders to comply."</p><p class="FreeFormA">DLI says it has had "a few complaints in the past" — but since there is no specific designation for complaints about expressing breast milk, it cannot report any specific number that it has addressed. The agency said it would add such a designation by July 1.</p><p class="FreeFormA">As a last resort for "willful or repeated violations," DLI may assess a civil penalty for each violation. The max penalty is $1,000.&nbsp;</p><h4 class="FreeFormA"><b>Nursing numbers rise</b></h4><p class="FreeFormA">If you want to start an ugly fight that raises the specters of old-fashioned gender politics and misogyny, just bring up the subject of making room for pumping breast milk in the workplace.</p><p class="FreeFormA">A January 2014 <a href="http://usnews.nbcnews.com/_news/2014/01/10/22257760-pumped-up-breastfeeding-mothers-fight-for-rights-at-work?lite" target="_blank">NBC News story</a> on the subject generated over 1,500 comments, many of which are stomach-churning. (<a href="http://usnews.nbcnews.com/_news/2014/01/10/22257760-pumped-up-breastfeeding-mothers-fight-for-rights-at-work%23th3916076-c81602662" target="_blank">For example</a>:&nbsp;"and this is why women get paid less. I for one will not be hiring any women in their prime childbearing years. You can be a mother or you can be a worker. You cannot give 100% to both. At best you can half-ass them both to a degree.")</p><p class="FreeFormA">Converging social trends suggest clashes between breastfeeding moms and bigoted or space-challenged employers are going to grow.</p><p class="FreeFormA">In 2010, <a href="http://www.cdc.gov/breastfeeding/pdf/2013breastfeedingreportcard.pdf" target="_blank">77 percent of U.S. newborns</a> began breastfeeding. At six months, the percentage drops to 49; at 12 months, 27 percent — but both figures are up by double-digits in a decade.&nbsp;</p><p class="FreeFormA">Over the same decade, <a href="http://www.pewsocialtrends.org/2013/05/29/breadwinner-moms/" target="_blank">40 percent of American households</a> had mothers as the sole or primary breadwinner, up from 32 percent. According to&nbsp;2013 data,&nbsp;<a href="http://www.bls.gov/news.release/famee.t06.htm" target="_blank">57 percent of women with a child under the age of 1</a> participate in the workforce.&nbsp;</p><p class="FreeFormA">Minnesota's breastfeeding numbers are <a href="http://www.minnpost.com/second-opinion/2013/08/us-breastfeeding-rise-minnesotas-rates-lag" target="_blank">roughly comparable</a> to national averages, and the working-women share is <a href="http://www.minnpost.com/politics-policy/2011/01/he-cession-gave-women-edge-jobs-minnesota-are-effects-over-hyped" target="_blank">10 percent higher</a>.&nbsp;</p><h4 class="FreeFormA"><b>Case study: One McDonalds accommodates</b></h4><p class="FreeFormA">Most state organizations already breastfeeding-compliant, says Larry Bourgerie, of the Minnesota chapter of the Society for Human Resource Management. But, he added, "For the smaller companies, it could be more difficult. It might be a struggle for small companies that don't have space."</p><p class="FreeFormA">However, it's not just small companies that could struggle; big companies operate in small spaces, too.</p><p class="FreeFormA">Reddit's ziggyllama pointed out that she works in a corporate-owned Minnesota McDonalds with well over the 50-employee cutoff that makes the organization fall under even the federal ACA law. Anyone who has ever worked in or been in a franchised fast food joint knows every last inch is maximized; unless that modular lactation room is Dr. Who's <a href="http://www.bbc.co.uk/programmes/b006q2x0/profiles/tardis" target="_blank">Tardis</a>, there is no place for it in a highly engineered McDonalds restaurant. Or is there?</p><p class="FreeFormA">A couple years ago, a teenage mother and employee at a Pine County, Minnesota McDonalds named Sarah dropped onto the radar of Rebecca Fahning, a worksite lactation advocate and board-certified consultant.&nbsp;</p><p class="FreeFormA">Sarah wanted to breastfeed at work but was too intimidated to broach the subject with her manager. Fahning acted as a liaison and soon the McDonalds had set up a screened-off, designated section of the employee crew room for pumping.</p><p class="FreeFormA">The manager even held an employee educational meeting, warning that any employee caught harassing or teasing Sarah about pumping would be reprimanded.</p><p class="FreeFormA">"They were as accommodating as the situation would allow, I think," Fahning said.</p><p class="FreeFormA">Even though&nbsp;the lactation room in Sarah's case might not seem ideal for many — nor would it strictly comply with the new WESA standards — it demonstrates finding common ground in a workplace of changing requirements.</p><p class="FreeFormA">"It's tough. I think mothers need to advocate for themselves but at the same time, I sympathize with small business owners," Fahning said.</p><p class="FreeFormA">After Sarah got her space, she was surprised to discover several of her colleagues had also been secretly pumping, in their car, or wherever they could. Maybe Reddit user&nbsp;ziggyllama&nbsp;was one of them. Today, other McDonalds employees use the room Sarah advocated for.</p><h4 class="FreeFormA"><b>Case study: Walmart’s resistance </b></h4><p class="FreeForm">Fahning’s experience with McDonald’s is refreshing, but not all employers are as cooperative.&nbsp;</p><p class="FreeForm">"We had a bunch of pregnant girls that all worked at the same Walmart," said a Minnesota WIC (Women, Infants, and Children) coordinator who asked that she not be named as she still works with area employers.</p><p class="FreeForm">When the WIC coordinator called Walmart to partner on facilities and systems to support pumping mothers "they wanted nothing to do with that," the coordinator said — adding that a Walmart personnel staffer said if a mom wanted to pump, she should talk to management.&nbsp;"There was no way they were even going to let us come and visit," the WIC representative said.&nbsp;</p><p class="FreeForm">"The room was a disaster," said Melissa A., one of the new mothers WIC tried to help.</p><p class="FreeForm">Melissa, who still works at the same suburban Walmart, said three employees wanted to pump at work during that period. "One pumped in her car," Melissa said. "But then it got too hot for her outside."&nbsp;</p><p class="FreeForm">Through strength of personality, Melissa said she managed to pump for eight months while working. But she noted, "the urgency to clean a room for me wasn't there."</p><p class="FreeForm">Walmart management basically made it her problem, finally offering her an unsanitary storage room Melissa described as an "office closet." That was after management told her to pump in one of the fitting rooms.</p><p class="FreeForm">And it wasn't due to lack of space. Melissa said the building has plenty of options and the room she ended up using is not much more than a spillover storage space. She said after she stopped using and maintaining the room, it quickly filled with clutter again. Melissa said another employee recently tried to make pumping at the same Walmart work, but "she only lasted a week or two."&nbsp;</p><p class="FreeForm">Reached for comment, Grant, a manager with 19 years of experience at the Walmart in question who would not give his last name, said he was "not aware of anything to do with WIC." He said the location follows the Walmart corporate policy, adding that, "We provide a room when needed."</p><p class="FreeForm">When asked if there was currently a dedicated room for nursing employees to pump, he repeated, "We provide one when needed."</p><p class="FreeForm">The conversation was over.</p><p class="FreeForm">Melissa, who's proud of her confrontational personality, said that's part of the problem. "When needed" means Walmart strategically putting the onus on the employee to push for her legal rights. "Most of the women there are so intimidated by the store. They feel they're a little person going against the army," she said.</p><p class="FreeForm">"These employees are in a vulnerable position and are scared to death to lose their job," said the WIC coordinator. "So they are not going to walk in and say to their supervisor, 'I'm going to need two unpaid breaks during my 8 hour shift and I want a place that's private with a locked door.’ They're scared to death to do that."</p><p class="FreeForm">"Many women fear the consequences of asking for ‘special treatment,’ and that fear is not unfounded," said the Breastfeeding Coalition’s McCoy. "It is especially problematic for unskilled workers, where they may be easily replaced by a non-lactating worker. Many women in all professions find asking for accommodations intimidating, given the weird reactions some people in our society have."</p><p class="FreeForm">Ironically enough, Walmart sells <a href="http://www.walmart.com/search/search-ng.do?ic=16_0&amp;search_constraint=0&amp;search_query=breast+pump&amp;facet=breast_feeding_type%3AElectric+Breast+Pumps&amp;mmodule=1&amp;prevTerm=breast%20pump&amp;_mm=" target="_blank">dozens of breast pumps and fittings</a>.</p><p class="FreeForm">In fairness, locations seem to vary, suggesting the importance of understanding by individual Walmart managers. A Rancho Cordova, California Walmart won a Mother Baby Friendly Workplace Award from Breastfeeding Walk in 2008; meanwhile, a Louisiana Walmart employee <a href="http://www.wsfa.com/story/23532939/walmart-employee-complains-of-breastfeeding-backlash" target="_blank">made news last September</a> when she complained of severe workplace harassment when she tried to pump.</p><h4 class="FreeFormA"><b>Entrepreneurs’ solution</b></h4><p class="FreeFormA">Asked if Minnesota's expanded law could push some to employers to further discriminate against women, HR pro Bourgerie admits there are always outliers living in the past. But, he concluded, "It's not only a foolish business decision but it's a foolish human decision. It's a signal of a no-class organization."&nbsp;</p><p class="FreeFormA">Entrepreneurs are rushing into a legally widened breach.&nbsp;</p><p class="FreeFormA">Chris Fredriksen, the Director of Sales at California-based Allied Modular, says it takes only about three hours to install one of the company's modular, prefab Lactation Rooms. <a href="http://www.priveedesigns.com/lactating-rooms/" target="_blank">The smart-looking faux-wood rooms</a> can be configured for nearly any space.</p><p class="FreeFormA">The rooms start in the ballpark of $2,000 but can be more if installing power outlets (meeting the new Minnesota standard) are required. Fredriksen says interest in the company's rooms has been increasing quickly. It’s a solution that might not work in a cramped McDonalds, but could easily fit in a big-box retailer.</p>http://www.minnpost.com/health/2014/06/breastpumping-moms-gain-new-rights-does-minnesotas-new-women-s-security-law-have-enou#commentsGreater MinnesotaMetro AreaCapitolBusinessWomen's Healthbreastfeedingsingle motherswomen's healthwomen's rightsThu, 05 Jun 2014 13:49:04 +0000Abe Sauer87920 at http://www.minnpost.comNurses and addiction: He knows how and why it's possible to cross the linehttp://www.minnpost.com/mental-health-addiction/2014/05/nurses-and-addiction-he-knows-how-and-why-its-possible-cross-line
<p>Michael Humphrey knows firsthand what it means to be a nurse with a substance-use disorder. He understands, no matter how terrible the consequences, how on earth it is possible for nurses to cross the line. As an intensive care nurse for the University of Minnesota Hospital in the 1980s, he crossed that line himself.</p><p>“I never stole from patients — I didn’t have to,” he said. The leftover fentanyl after an open-heart surgery was there for the taking. “But I would have,” he said, likening addiction to “the person who is drowning and taking down the rescuer.”</p><p>Recovery came hard for Humphrey, who grew up in Brainerd in a family that demanded extreme self-reliance. After his first inpatient treatment experience (in 1989), “I fully expected to walk out 28 days later with no desire to use narcotics anymore,” he said. “But I threw away the Big Book in a garbage can on my way out the door.”<b></b></p><p>After relapsing (more than once), losing his license for a year, losing a business and going through two divorces, a strong sponsor and an equally strong therapist nudged him into a new state of mind and a deeper understanding of himself. They also nudged him into a new career — in the field of addiction treatment and recovery.</p><p>Humphrey now is director of the new <a href="http://www.hazelden.org/web/public/nursesprofessionaltrackforaddictiontreatmentandrecovery.page" target="_blank">specialty treatment track</a> program for nurses at Hazelden Betty Ford Foundation in Center City, Minn. Since it began in September, the program (which was announced early in May) has served more than 87 nurses from across the United States.</p><p>MinnPost asked Humphrey about what problems and challenges might contribute to addiction among nurses, and what’s missing in the way of help.</p><p><b>MinnPost: What motivated Hazelden Betty Ford to create a specialty treatment track for nurses?</b></p><p><b>Michael Humphrey</b>: The evidence shows that the recovery rate of nurses is about half that of physicians [45 percent compared with 90 percent, respectively]. There are a lot of different variables. One that is most apparent is resources. Physicians are much more likely to be able to afford a longer duration in primary treatment.</p><p>Another [variable] is the working environment. ... A doctor may prescribe a narcotic, the nurse actually has it in her hands. The physician has the knowledge of the pain relief associated with it, but as a nurse, you actually see the patient. You give them a pill, they haven’t been able to get out of bed, it takes two people to get them out of bed, suddenly you get them out of bed and up to the bathroom, and they’re standing there pain-free wanting their razor. So there’s this endorsement — it’s like living in an advertisement because you see the results of it.</p><p>Another big component is gender specific. Ninety-two percent of nurses are female. There’s a huge stigma surrounding women and substance-use disorder. Society will grant a lot of latitude for a man to overindulge and have some catastrophic events, but that same latitude is not granted to women.</p><p>We’re finding that the nurses who are coming into the program are sicker than the general population. ... A female nurse will go to a prescribing physician and will complain of anxiety and depression, and be treated for it, but they’ll leave out the alcohol use. So that medication will just further their addiction.</p><p><b>MP: Addiction has been called an “occupational hazard” for nurses. Do you agree with that?</b></p><p><b>MH: </b>There’s a fair amount of injury on the job — lifting patients and that sort of thing. And the work environment requires a lot of scrambling, a lot of thinking outside the box. It’s a very intense job. You may be taking care of five patients, and say you have one who goes into cardiac arrest. You may be tied up with that for 45 minutes. You’ve just set yourself back, and you still need to catch up with the other patients.</p><p>There’s a nursing shortage. There always will be a nursing shortage. So you’re understaffed. You are subjected to physicians coming and doing rounds on their patients, and you need to make them feel as if their patients are the only ones you’re really taking care of. And that’s just a part of the culture of nursing. The culture is changing: In the old days, nurses would stand up when the doctor came onto the unit, and there was a definite pecking order. That’s just the way it was, and it was pretty much universal. That still exists to a great degree.</p><p>It’s an occupational hazard in that there are very, very high expectations. And it’s nearly impossible to meet them.</p><p><b>MP: What’s your impression of the size of this issue?</b></p><p><b>MH: </b>I think it’s underreported<b>. </b>I actually think that the rate of addiction among nurses [reported to be 1 in 10, as in the general population] is much, much higher. “Liver checks” and “liquid rounds” are some of the designations [for use]. Going out for a drink after work is widely accepted. It’s a great stress reliever. It’s accepted if you are inebriated and a little bit out of control. It’s part of the culture.</p><p><b>MP: Because of patients’ vulnerability, nurses struggling with addiction it seems are especially subject to judgment. How do you help nurses come to terms with crossing the line?</b></p><p><b>MH:</b> That’s one of the major stumbling blocks. And it’s one of the reasons we have a separate nursing group, so people feel free to talk about their crossing of moral lines.You feel very much alone — that you’re the only one who’s ever done that. And I think it helps to be with a cohort and establish a commonality. “Yes, we have crossed moral lines. Now what do we do about it?” Well, let’s look at what substance-use disorder is. It is a disease, and you don’t need to ever go back to crossing those moral lines. And therefore you’re at a crossroads: It’s not that you can erase anything you’ve done. But you can restore the relationships and restore trust the best that you can, only with more realistic expectations of oneself, more boundary setting — these sorts of things.</p><p>Self-forgiveness is probably the most difficult thing — more so among women than men. Failure as a mother, failure as a caregiver [produces] mounds of shame. You’ll find people unable to forgive themselves. It takes a lot longer, due to stigma but also their own idea that “I have been a failure, and I’m no good.”</p><p>We make a big point of looking at guilt versus shame. Guilt is a good person who has done something wrong. Shame is, “I’m just a bad person.” So many people are in that shame mode and have a core belief that they are bad. You need to start to have forgiveness, to know that there’s hope of never having to cross those lines again, and that you can continue to move forward.</p><p>A nursing team is very special. You’re all team players and you really have to cover for each other. You’re very dependent on each other. So when people reenter that environment, they carry a lot of shame because it’s hard for them to get over the fact that they have done careless work, have let the team down, and the nurses who are receiving people back are oftentimes not very forgiving.</p><p><b>MP: What are some other barriers to recovery?</b></p><p><b>MH: </b>Nursing chooses nurses before they choose nursing. Nurses come from dysfunctional families — some studies have found that as many as 70 percent come from some kind of abuse situation or other dysfunction. When somebody becomes a caretaker very young, their brain is still in development. They become a responsible adult at a time when they should be being nurtured. They start to develop these truths, but more than that they develop expectations and lifestyles that compel them to put the care of others above their own. It would be great to have some research, but most of this is anecdotal.</p><p>The establishment of a strong person comes very early ... and therefore there’s a lot of self-reliance. Therefore you’re not going to go to anybody to talk about your problem. You’ve been taking care of yourself all these years, and all of a sudden there’s a failure of the ability to do that.</p><p><b>MP: Are there some nurses who leave treatment understanding that they must leave their professions?</b></p><p><b>MH:</b>&nbsp;Most are able to reenter when recovery is achieved, but some may move to a different area. It’s interesting because you can look at specialties in nursing and see a <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508454/" target="_blank">different style of using</a>: Hospice nurses are typically binge drinkers. Emergency room nurses have higher use of stimulants and marijuana. They [the latter] enjoy the drama and the trauma, and perhaps that may not be well-suited to recovery because it will drag them back into the adrenalin rush.</p><p><b>MP: What’s missing in the way of supports for nurses who are struggling?</b></p><p><b>MH: </b>Minnesota is the land of 10,000 addiction centers, a hot bed for recovery. But it’s somewhat amazing that we haven’t been able to recognize and create cohort groups for nurses. Although there have been some grassroots support groups for nurses, they tend to die out. They’re not very well-established. What’s needed is a formalized peer assistance group for nurses. Addiction is treated fairly aggressively by the Board of Nursing. And that’s not a judgment thing, but I think that it does keep people away from treatment.</p>http://www.minnpost.com/mental-health-addiction/2014/05/nurses-and-addiction-he-knows-how-and-why-its-possible-cross-line#commentsGreater MinnesotaMetro AreaMinneapolisSt. PaulTwin CitiesGeographyINNWomen's Healthaddictionaddiction treatmentanesthesiologyfentanylnursesnursingopioidspainkillersTwelve StepsFri, 30 May 2014 14:04:40 +0000Sarah T. Williams87824 at http://www.minnpost.comRoot canals cause cancer! (and other spurious correlations)http://www.minnpost.com/second-opinion/2014/05/root-canals-cause-cancer-and-other-spurious-correlations
<p>Over the weekend, I came across an article via Facebook about the great “root canal cover-up.”</p><p>The article charges that dentists have known for almost a century that root canals can unleash “pathological bacteria” into people’s bodies, which can then trigger all sorts of diseases, including multiple sclerosis, amyotrophic lateral sclerosis (ALS) and cancer.</p><p>My health-scam antennae immediately went up, of course. And, indeed, the article was nothing more than a ridiculous collection of fearmongering misinformation that ended (as I suspected it would) with a sales pitch for some kind of dental herbal supplement.</p><p>Some “facts” in the piece were so ludicrous, however, that I find it difficult to understand how anybody would believe them. At one point for example, the author cites a German doctor who apparently claimed that “in his 40 years of treating ‘terminal’ cancer patients, 97 percent of his cancer patients had root canals.”</p><p>Well, gosh, I guess that proves it then. Root canals cause cancer.</p><p>What it actually proves, of course, is that people still don’t understand the difference between correlation and causation. Because even if (and it’s a huge, huge if) the doctor had kept meticulous records of the dental history of his cancer patients and 97 percent of them did have a history of getting a root canal, that would prove absolutely nothing.</p><p>Just because two things occur together does not mean they are related to one another.</p><h4><b>Plotting uncanny correlations</b></h4><p>That’s made delightfully clear in a great new website called <a target="_blank" href="http://www.tylervigen.com/">Spurious Correlations</a>, which was started earlier this month by Tyler Vigen, a first-year Harvard Law School student.</p><p>By plotting data from the U.S. Census and the Centers for Disease Control and Prevention side-by-side, Vigen has been able to “discover” uncanny correlations between, say,</p><ul><li>the divorce rate in Maine and the per capita consumption of margarine (Eating margarine causes divorce!);</li><li>U.S. spending on science, space and technology and the number of suicides by hanging, strangulation and suffocation (Giving money to science causes people to kill themselves!), and</li><li>U.S. per capita consumption of cheese and the number of people who die from becoming tangled in their bed sheets (Eating cheese can cause you to suffocate in your sleep!).</li></ul><p>Vigen also “found” an inverted correlation between the number of bee colonies in the U.S. and juvenile arrests for possession of marijuana (Teens smoking pot is behind mysterious disappearance of honey bees in U.S.!).</p><h4><b>A start, not a conclusion<br /></b></h4><p>That’s not to say that uncovering correlations by good scientific research (and having those findings peer-reviewed and published in a journal for others to analyze and comment on) isn’t valuable. As Vigen explains in a delightful video that accompanies his website, finding a correlation can spur scientists to search for a cause.</p><p>Starting in 1939, he points out, scientists began publishing research showing a correlation between smoking and lung cancer. Those observational studies encouraged researchers to study the matter in the laboratory. Eventually, the correlation between smoking and lung cancer (and other diseases) was proven to be causative, which led, of course, to anti-smoking public health efforts that have saved countless lives.</p><p>But the medical field is also full of examples of correlations that ended up being false. Perhaps the most famous involves menopausal hormone therapy (HT). In the 1980s and 1990s, epidemiological research had found a correlation between the decrease in estrogen that occurs after menopause and an increased risk of cardiovascular disease. Other observational studies had also suggested that giving women HT at menopause lowered their risk of developing heart disease.</p><p>But when a large randomized controlled trial was conducted (the <a href="http://www.nhlbi.nih.gov/whi/">Women’s Health Initiative</a>), researchers found (much to their surprise) that taking HT actually <em>increased</em> women’s risk of cardiovascular disease, including blood clots, heart attacks and stroke. Subsequent analyses of the data have added other risks, including breast cancer and dementia.</p><h4><b>Needed: rational thinkers</b></h4><p>“Statistical data can show correlations, and then it’s up to us, rational thinkers, to determine if there is an actual connection between the data or if it’s merely a coincidence,” says Vigen in his video.</p><p>First, we need to do the math to determine whether the correlation actually exists, he explains. And then we need to establish the why.</p><p>And that requires good scientific research.</p><p>Unfortunately, most people read about correlations — even spurious ones (Root canals cause cancer!) — and assume it means causation.</p><p>Maybe websites like Vigen’s, which is both amusing and educational, will help. (He received a million hits on the site within the first week alone.)</p><p>I hope so. But it’s been my experience that getting people to understand the difference between correlation and causation is like, well, pulling teeth.</p><p>You can watch Vigen’s energetic explanation of correlation vs. causation below.</p><p><iframe frameborder="0" height="360" src="//www.youtube.com/embed/g-g0ovHjQxs" width="640"></iframe></p>http://www.minnpost.com/second-opinion/2014/05/root-canals-cause-cancer-and-other-spurious-correlations#commentsScienceWomen's HealthcausationcorrelationHealthmedical researchpeer reviewrandomized trialsScienceTue, 27 May 2014 14:13:57 +0000Susan Perry87768 at http://www.minnpost.comCriminalizing pregnant women who use illegal drugs: 'Throwing a lit match'http://www.minnpost.com/mental-health-addiction/2014/04/criminalizing-pregnant-women-who-use-illegal-drugs-throwing-lit-matc
<p>When the Tennessee General Assembly voted last week to <a href="http://www.timesfreepress.com/news/2014/apr/18/tennessee-bill-would-punish-drug-using-pregnant-wo/" target="_blank">criminally prosecute women who use illegal narcotics during pregnancy</a>, it ignored, among other things, the major medical community’s longstanding warnings about the negative and counterproductive effects of such punitive measures.</p><p><a href="http://wapp.capitol.tn.gov/apps/billinfo/BillSummaryArchive.aspx?BillNumber=SB1391&amp;ga=108">The bill</a>, sent to Gov. Bill Haslam for consideration April 16, allows for felony assault charges against a woman “if her child is born addicted to or harmed by the narcotic drug, and the addiction or harm is a result of her illegal use of a narcotic drug taken while pregnant.” (A conviction can get you 15 years in prison.)</p><p>A woman may be protected from prosecution, the bill says, if she “actively enrolled in an addiction recovery program before the child is born, remained in the program after delivery, and successfully completed the program, regardless of whether the child was born addicted to or harmed by the narcotic drug.”</p><p>But the threat of prosecution is the very thing that prevents women with substance use disorders from seeking help, medical professionals say — and not all women will have equal access to care and treatment options.</p><p>Here’s a sampling of their many cautionary statements over the years:</p><p><a href="http://www.asam.org/docs/publicy-policy-statements/1womenandpregnancy_7-11.pdf" style="line-height: 1.5em;" target="_blank">The American Society of Addiction Medicine</a>: “Incarceration of pregnant women as a means of preventing fetal exposure to alcohol or other drug use may compromise both maternal and fetal health and inhibit the pregnant woman’s opportunity to receive effective treatments to address her long-term recovery from her substance-related disorder.”</p><p><a href="http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Health_Care_for_Underserved_Women/Substance_Abuse_Reporting_and_Pregnancy_The_Role_of_the_Obstetrician_Gynecologist" style="line-height: 1.5em;" target="_blank">The American College of Obstetricians and Gynecologists</a>: “Seeking obstetric–gynecologic care should not expose a woman to criminal or civil penalties, such as incarceration, involuntary commitment, loss of custody of her children, or loss of housing. These approaches treat addiction as a moral failing. Addiction is a chronic, relapsing biological and behavioral disorder with genetic components. The disease of substance addiction is subject to medical and behavioral management in the same fashion as hypertension and diabetes.”</p><p><a href="http://www.google.com/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=1&amp;ved=0CCgQFjAA&amp;url=http%3A%2F%2Fwww.psych.org%2FFile%20Library%2FAdvocacy%20and%20Newsroom%2FPosition%20Statements%2Fps2001_PregnancyAddiction.pdf&amp;ei=4y5aU8auN9fKsQTo4oCwCg&amp;usg=AFQjCNEa4dnqlOECHBE_Z7ia6D4wLILD0g&amp;sig2=xW0zMRj0Q83AHrzdWjtY4Q&amp;bvm=bv.65397613,d.cWc" style="line-height: 1.5em;" target="_blank">The American Psychiatric Association</a>: “APA urges that societal resources be directed not to punitive actions but to adequate preventive and treatment services for these women and children. APA strongly advocates the development and funding of the necessary inpatient, outpatient, and residential programs for mothers with their children. Services should address and foster the parental functions, as well as the care of individual mother and child.”</p><p></p><div class="image float-right"><img class="imagecache-article_detail" src="/sites/default/files/imagecache/article_detail/MicheleGoodwin115.jpg" alt="Bratcher Goodwin" title="Bratcher Goodwin" /><div class="caption">Bratcher Goodwin</div></div><p><a href="http://www.law.umn.edu/facultyprofiles/goodwinm.html" target="_blank">Michele Bratcher Goodwin</a>, Everett Fraser Professor in Law at the University of Minnesota Law School, has made a close study of such policing efforts, especially their impact on drug-addicted poor women of color.</p><p>Tennessee’s proposed law, she said in an interview this week, “is like throwing a lit match in a very dry and hot place, and the kerosene is already there.” Here’s a summary of her many issues with this and other such laws.</p><p><b>They criminalize drug dependency, which is an illness:</b></p><blockquote><p>Taking away women’s liberties for something that we know is a medical condition, such as drug dependency, is criminalizing drug dependency. The U.S. Supreme Court said decades ago that criminalizing drug dependency is like criminalizing someone for having the flu.</p></blockquote><p><b>They target women of color:</b></p><blockquote><p>For decades, across the United States, we have been criminalizing poor women of color for drug use during pregnancy. And there are significant disparities. For example, we know that physicians are 10 times more likely to report an African American woman for her illicit drug use during pregnancy than a white woman.</p><p>And ... because they’re poor, they usually don’t have access to good criminal defense attorneys. And even the criminal defense attorneys who are sympathetic are often not well-versed in cases such as this.</p><p>So those who end up in situations where they are prosecuted under laws for posing some sort of harm to their fetuses usually end up accepting some plea bargain. Their cases rarely end up fully adjudicated in front of a jury because they’re coerced and pressed into taking a plea deal.</p><p>Anyone can see what kind of leverage a prosecutor can use. For example, a woman who happens to be less educated and poor is told, “Oh look, we’ve got this evidence that your drug use killed your baby." Or "Your drug use affected your baby in this way.” They don’t have the resources to mount a good defense that would include bringing in witnesses who testify, and say, “That’s not true.”</p></blockquote><p><b>They apply different standards based on class:</b></p><blockquote><p>Let’s face it: Any woman who happens to be well-to-do who suffers psychological challenges during her pregnancy can seek medical treatment through her doctor and receive prescription medication. And many women do. In fact the empirical evidence suggests that the wealthier a woman is, the more educated [and white] she is ... chances are that during her pregnancy, she’s taking a prescription medication — often cocktails of prescription medications.</p><p>The truth of it is ... there’s a different level of moral scrutiny applied based on the type of drug that a woman takes during pregnancy. If it’s prescription medication, we treat that as a morally neutral thing or morally appropriate that the woman receive what we consider to be that type of care — to help and assist her during her pregnancy. And yet a woman who is poor, who lacks access to a physician, and who takes essentially the same kind of drug, except that it’s provided by a dealer on the corner, loses any of that of compassion, any of that moral authority to treat the challenges that she has during her pregnancy, which are no different from the challenges that a woman who happens to be wealthier and more educated has during her pregnancy.</p><p>So there is a very different lens that is applied simply based on class.</p></blockquote><p><b>They reinforce stereotypes and misinformation:</b></p><blockquote><p>For example, the “crack-baby” scare was incredibly successful during the 1980s, 1990s, and the beginning of the 2000s — based on very faulty information that was spread in the media. In fact, last year <a href="http://www.nytimes.com/2013/05/20/booming/revisiting-the-crack-babies-epidemic-that-was-not.html" target="_blank">the New York Times</a> ... acknowledged that they and other media outlets got it wrong, that they relied on faulty information and published stories that could not be verified and that we know today happen to be simply untrue in terms of crack causing conditions that would lead to the babies being malformed, with smaller brains, with distended genitalia — all sorts of crazy things that were written about in the 1980s that now we know are absolutely just not true. So one of the problems with this, too, is that it helps to reify certain types of stereotypes that are quite problematic.<b></b></p></blockquote><p><b>They corrupt the doctor-patient relationship:</b></p><blockquote><p>Part of what happens is that states seek to use doctors as gatekeepers, as law enforcement. And this is bad because the public understands their relationship with their doctors to be based on something that involves a fiduciary relationship, which suggests that it’s a very special kind of relationship, where the doctor owes his or her loyalty to his or her patient. The doctor must place all other interests to the side because the primary interest has to be serving the needs of the patient. This also includes preserving the confidentiality of the communications between the doctor and the patient.</p><p>Now when law enforcement gets involved in that, it completely distorts this relationship that we come to — expecting care, expecting trust, and expecting that we are the primary beneficiaries of the doctor’s work. That goes out the window in these cases where the state expects the doctors to become their enforcers, to become their snitches. It reprioritizes the medical relationship.&nbsp;So the doctor might otherwise say, "What I need you to do is to get into this rehab program. So here’s a course of action that I recommend for you."</p><p>Instead, when law enforcement places this kind of onus and burden on doctors, then law enforcement ... expects for doctors to just call the prosecutor’s office and call police. That completely shortchanges the doctor’s attempt to try to get appropriate medical services to the patient.</p><p>And one final thing that I think is really problematic in terms of the physician-patient relationship is that our criminal justice system requires that when a person is being sought by the state for breaching the law in some way, the state has to inform that person that what that person says, what that person does, may in fact incriminate that person. They have to inform the person that this is a criminal matter and that the person has the right not to respond and that the person also has the right to engage an attorney.</p><p>Doctors do not provide that information, but this is the gateway to prosecution. Women are being arrested right after seeing their physicians and disclosing information that they believe will be held in confidence. It’s a complete a breach of our constitutional norms in the criminal justice system.</p></blockquote><p><b>They break up families, and funnel the children of prisoners into the criminal justice system:</b></p><blockquote><p>Many of these women are already moms, they’re primary caregivers ... [and] children end up in the criminal justice system pipeline because they end up in foster care, and foster care is a criminal justice pipeline. There are very provocative <a href="https://ssa.uchicago.edu/extending-foster-care" target="_blank">studies</a> being done at the University of Chicago and the University of Wisconsin that detail these horrific outcomes for children who are in foster care who age out [turn 18] and ... have parents who are in prison. They have higher incidence of dropping out and higher incidence of being involved in the criminal justice system. For the girls, over 70 percent end up pregnant themselves by the time they age out.</p></blockquote><p><b>They allow the state to try to achieve a public good in an unconstitutional manner:</b></p><blockquote><p>No one wants to see a woman using drugs during pregnancy, and ideally we want all babies to be born healthy. But we cannot discriminate between classes of pregnant women, and target only poor pregnant women. Nor is it permissible for the state to try to achieve a good goal in an unconstitutional way. Hundreds of years of constitutional law tells us that even when the state thinks that it’s going to be something good, it can’t break the law to do it. It can’t violate someone’s constitutional right in order to try to achieve a good, including a public-health good with fetuses.</p></blockquote>http://www.minnpost.com/mental-health-addiction/2014/04/criminalizing-pregnant-women-who-use-illegal-drugs-throwing-lit-matc#commentsWomen's Healthaddictionaddiction treatmentchild protectionfoster carepregnancyTennesseeFri, 25 Apr 2014 13:46:12 +0000Sarah T. Williams87297 at http://www.minnpost.com